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Alzehimer recalls

1. ttt of alzeheimer: tacrine (cholinesterase inhibitor), donepezil


2. Dementia: mental deterioration
3. Maximum dose of Donepizil
4. Donepzil maximum dose:10 mg/day
5. Maximum dose of Donepizil
6. Donepzil maximum dose:10 mg/day
7. Donepezil- what is the maximum dose?

Anesthetics recalls

1. Thiopental sod is ultra short acting general anesthetic due to its high lipid solubility
2. Thiopental is highly lipid soluble thus cross the BBB
3. Procaine is so liable to destruction by heat
4. Procaine is liable to destruction upon sterilization by heat
5. Procaine HCl is thermolabile
6. Most IV anesthetics are barbiturates except ketamine
7. Most IV anasthetics are barbiturates e.g. thiopental, thiamylal, methohexital … an
exception is: ketamine
8. Local anesthetic NOT dministered topically is procaine
9. Lignocaine is long acting because it has amide structure BUT procaine is NOT
10. Lignocaine has longer duration of action because of its amide group which resists
hydrolysis
11. Lidocaine or lignocaine is not taken orally because it undergoes first pass effect
12. ketamine HCl (ketalar, ketaject): nonbarbiturate anesthetic, IM, IV, used for both
diagnostic and minor surgical anesthesia
13. Halothane is inhalational NOT IV
14. Ethylaminobenzoic acid (benzocaine): local, topical anesthetic, benzoic acid derivative,
rapidly hydrolized in boiling water, insoluble in water but soluble in mineral acids
15. Droperidol is used as adjunct to anesthetics
16. Aromatic esters are: benzocaine, tetracaine, procaine -- aromatic amides are: lidocaine,
bupivacaine, mepivacaine
17. Adrenaline is given with local anesthetics to enhance their action by vasoconstriction
18. Adrenalin is given with local anesthetic to prolong their duration
19. Decompose by heat sterilization: procaine
20. What casues acute intermittent porphyria… Enflurane, ketamine, propofol, etomifate
21. Thiopental Na is ultrashort acting phenobarbital due to its high lipid solubility
22. Procaine is so liable to destruction upon heat
23. Procaine is not used topiclly
24. Procaine hydrolysis gives PABA
25. Lignocaine has longer duration of action because it has amide group that resists
hydrolysis
26. Droperidol is used as an adjuvant to anesthesia
27. Conscious anesthesia: fentanyl + midazolam
28. Chloral hydrate dose: 0.3-2 gm
29. Benzocaine is a benzoic acid derivative that is used as local and topical anesthetic,
rapidly hydrolysed in boiling water but in soluble in water and soluble in mineral acids--
as it reacts with HCl, forms soluble salts thus be soluble
30. NO anesthesia characterized by rapid induction
31. Lignocaine doesn't make CNS stimulation
32. Which one if sterilized by heat will decompose: procaine
33. Which one if sterilized by heat will decompose: procaine
34. The clearance of Lignocaine has been decreased...Ans. Due to reduced blood supply to
the liver
35. Lignocaine long action due to : amide
36. Lignocaine long action due to : amide

Angina recalls

1. When used to treat angina, nifedipine is much more likely than verapamil and diltiazem
to cause tachycardia, because verapamil and diltiazem significantly decrease
intracardiac conduction
2. Ventricular fibrillation is the most common complication of myocardial infarction
3. The most specific laboratory investigation for MI cardiac troponin
4. The major determinant of myocardial oxygen deman is cardiac output
5. The best way to prescribe GTN is: (transdermal) absorbed through the skin
6. SE of GTN is throbbing headache
7. Risk factors of athersclerosis: smoking, family history, HTN, hyperlipidemia, BUT
rheumatic fever is NOT RELATED
8. Pt with angina and have hypertensive crisis should take Na niroprusside by slow IV
infusion instead of diazoxide because of its cardiostimulating effects
9. Pain of angina is due to ischemia of certain area of the myocardium
10. Normal therapeutic dose of glyceryl trinitrate is 0.5-1mg
11. Nitrogycerin inc c-GMP = vasodilation
12. Nitrates are given sublingually because (to avoid) 1st pass effect NOT destroyed by
gastric acid
13. Nifedipine when used in angina is more likely to produce tachycardia than verapamil
and diltiazem
14. GTN: venodilator: dec blood return to the heart: dec preload
15. GTN tab:0.6mg, spray 400-600mcg/spray
16. Glyceryl nitrate is absorbed from the skin
17. Fibrinolytic in MI is C.I. in duodenal ulcer pts
18. CPK level inc in MI
19. Angina pectoris is due to ischemia of the heart muscle NOT due to MI
20. Amyl nitrite is the only antianginal inhalation
21. Propranol in angina..- to block catecholamine action in heart...- beta blocker agonist.
22. "Which one is wrong regarding the tolerance of nitrates?a) Tolerance is rare with
Isosorbid dinitrate (ISDN) b) Tolerance is high with Isosorbid mononitrate (c)Schedule of
taking nitrates causes torleance
23. "
24. Nitroglycerine could be used by which methods ..Oral , Iv , transdermal
25. Perhexiline interactions
26. Which one is wrong regarding the tolerance of nitrates? a) Tolerance is rare with
Isosorbid dinitrate (ISDN) b) Tolerance is high with Isosorbid mononitrate ( c)Schedule of
taking nitrates causes torleance (or someting like this)
27. Which dec risk of MI : atenolod or nifedipine
28. Propanol in angina - to block catecholamine action in heart - beta blocker agonist
29. Nitroglycerine could be used by which methods Oral , Iv , transdermal
30. Betaxolol can make worse which one of the cardiac condition........Ans. aortic stenosis
31. Ventricular fibrilation is the most common complication of MI
32. Alcohol, sildenafil: vasodilators thus C.I. with NTG
33. Prehexilene drug interaction
34. Antibiotics recalls
35. Tolnaftate is ineffective against candida
36. Worms that are present in humans but not in animals:: ascaris, anclystoma, oxyrious --
worms in men and animals:: faschiola, hetrophes (fish), ?? -- in animals only: ??
37. Vancomycin is used to treat antibiotic-induced pseudomembranous colitis
38. Tubocurarine should not be taken with gentamicin
39. ttt of methicillin resistent staph is vancomycin
40. Trimethoprim cause photosensitivity
41. Tombramycin and streptomycin resemble each other, both are aminoglycosides
42. Tobramycin structure is similar to gentamicin
43. Tobramycin make hearing loss
44. Tobramycin causes hearing loss by affecting:: both auditory and vestibular beanches of
the 8th cranial nerve may be adversely affected. Ototoxic damage may be reversible in
up to half of the cases
45. Ticarcillin is preferred to carbenicillin for pts with CHF , renal failure or HTN because it is
used in smalled doses than carbenicillin
46. Ticarcillin is preferred than carbenicillin because it is given in smaller doses
47. Thrush= oral fungal infection (candidiasis)
48. The purpose of combined drug ttt in TB: dec and delay drug resistence, inc anti-TB
effect. NO effect on duration
49. Tetracyclines side effects : renal damage , hepatic damage , tooth discolouration
50. Tetracycline should not be taken in pregnancy
51. Tetracycline is contraindicated in pregnancy
52. Tetracyclin should not be given to neonates because it leads to discoloration of teeth
53. Tetracyclin SE: discolorization of teeth
54. Tetracyclin in C.I in pregnancy
55. Tetracyclin gives different patterns of absorption and dissolution because it is
amphoteric : forms salts with acids and bases and is capable of forming internal salt
56. TB: mantox test, tuberculin test
57. Systemic anaerobic infection is ttt by metronidazole
58. Syphilis ttt: penicillin G, quinolone, chloramphenicol
59. Synergism between sulfamethoxazole and trimethoprim is because they block
sequential steps in folic acid synthesis pathway preventing DNA syn
60. sulpha preparations are long acting because of PPB
61. Sulfonamides SE: rash, fever, blood dyscrasias
62. Sulfonamides SE: blood dyscrasias, rash, fever, steven-johnson syndrome
63. Sulfonamide must have a non substitute amino group essential for antibacterial activity
64. Sulfonamide best suited for the topical prophylactic ttt of burns: mafenide (sulfamylon
cr), silver sulfadiazine. NOT: sulfacetamide, sulfameter, phthalylsulfathiazole,
sulfamethoxypyridazine.
65. Sulfisoxazole causes kernicterus in neonates
66. Sulfamethoxypyridine is long acting due to plasma protein binding
67. Sulfamethoxypyridine is long acting as it is highly bound to plasma protein
68. Sulfa drugs are not liable to destruction by heat
69. Streptococcus viridans: subacute bacterial endocarditis, ttt ampicillin + aminoglycoside -
-- streptococcus pyrogens: throat, scarlet fever, rheumatic fever --- streptococcus
fecalis(enterococci F.): nosocomial hospital infection
70. Steven johnson syndrome: SE of sulfisoxazole
71. Staph. Aureus: bone infection -- clostridium difficile: pseudomembranous colitis -- Ecoli:
UTIs, meningitis -- proteus mirabilis: UTI, Ps. Auroginosa -- treponema pallidum: syphilis
72. Spectinomycin is used for ttt of gonorrhea in pts with sensitivity to penicillin or with
resistent gonococci
73. Slow acetylators develop rapid neuropathy with INH
74. SE of vancomycin: ototoxicity
75. SE of pentamidine: severe hypotension
76. SE of nalidixic acif: photosensitivity, visual disturbances (as amiodarone)
77. SE of ketoconazole is gynecomastia and hepatotoxicity
78. SE of INH is peripheral neuritis
79. SE of clindamycin: diarrhea
80. Safest sulfonamide to allergic pts is sulfamethizole
81. Safest sulfonamide to allergic pt is sulfamethizole
82. Rifampine cause damage to contact lenses , urine discolouration
83. Rifampicine cause red urine
84. Rifampicin may cause orange colouration of contact lense
85. Rifampicin is taken before meals, it is taken with INH to dec bacterial resistance
86. Rifampicin cause descoloration of lens, urine, sweat
87. Radial walker test: disinfectant and germicidal action
88. Quinolone SE: CNS stimulation
89. Quinolone # DNA gyrase -- erythromycin # protein synthesis -- streptomycin # protein
syn (# 30S) -- TC # protein syn (30S) -- chloramphenicol # protein syn (50S)
90. Pyrvinium Pamoate tablets: cause N,V,D - swallowed whole without chewing, stain stool
red for several days, should not be used in pts with inflammatory conditions of GIT
91. Pyrivinim pamoate is a dye used in the ttt of pinworn in humans
92. Pyrazinamide: arthrlgia + hyperuricemia
93. Pyrazinamide SE: arthralgia ( inc uric acid in blood) --- ethambutol SE: red-green
blindness
94. Purulent boils in the ear are usually caused by staph
95. Pt with ampicillin allergy should not take imipenem
96. Pt on erythromycin and warfarin for 5 days:: dec warfarin to half for 5 days
97. Pt allergic to penicillins sould not take carbapenems
98. Pseudomembranous colitis ttt: vancomycin, metronidazole, TC
99. Primaquine cause hemolytic anemia in G6PD deficiency
100. Pregnants allergic to penicillin V should take erythromycin
101. Postmenoposal vaginal infection is by: E-coli
102. Polymixin B is similar to bacitracin (colistin)
103. Photosensitivity is SE of nalidixic acid, griseofulvin
104. Photosensitivity is SE of nalidixic acid and griseofulvin
105. Phenyl murcuric nitrate is nonirritant bacteriostatic
106. Phenyl Hg nitrate: preservative in eye drops, sporocidal
107. Phenyl Hg nitrate in low doses is sporocidal
108. Pheny Hg nitrate use: sporocidal
109. Phenazopyridine is effective as urinary analgesic
110. Phenazopyridine (pyridium): urinary tract analgesic, causes red urine
111. Pentids (penicillin G tablets): take on an empty stomach.. In order to limit
destruction by acid hydrolysis, penicillin G tablets should be taken on an empty stomach
when gastric acid is at its lowest level. Pentids taken 1hr before or 2hr after meals
112. Pentamidine: ttt of PCP in HIV
113. Penicillinase-resistant penicillins: methicillin, nafcillin, cloxacillin, dicloxacillin
114. Penicillinase resistant penicillins : methicillin, nafcillin, cloxacillin,
dicloxacillin,fluoxacillin, oxacillin
115. Penicillin should be taken 1/2 hr before food
116. Penicillin should be administered on empty stomach
117. Penicillin is recommended on empty stomach BUT NOT diazepam
118. Penicillin is excreted by tubular secretion from kidney but aminoglycosides by
GF
119. Penicillin has a B-lactam ring - erythromycin has a lactam ring
120. Penicillin allergic pts should shift to erythromycin not cephalosporins
121. Pencillin # transpeptidase enzyme
122. Pencillin # cell wall syn by # of transpeptidase
123. Oxacillin=penicillinase resistant
124. Otitis media, sinusitis are caused by: H.inf, strept.pneumonia, moraxella --- ttt:
amoxicillin, TMP-SMZ, cefixime, cefaclor
125. Nystatine is used for ttt of candida
126. Nystatine is D O C for moniliasis ( candidiasis )
127. Nystatine can be taken topically NOT ketoconazol, griseofulvin ??
128. Nystatine advice: swish ans swallow
129. Nystatin # candida albicans -- griseofulvin # tinea capitis -- streptomycin # TB --
penicillin G# gonococci -- dapsone # leprosy
130. Not taken with metronidazole = alcohol
131. Nitofurantoin is useful against g+,-ve UTIs, more effective in acidic urine
132. Niclosamide is used in the ttt of tapeworm
133. Niclosamide is used in tape worm infections
134. Niclosamide is used for ttt of tapeworm
135. Nalidixic acid can cause phototoxic reaction
136. Nalidixic acid absorption is decreased by food, antacids
137. Nafcillin=penicillinase resistant
138. Na/K acid phosphate : dec urine pH : inc methenamine activity
139. MRSA ttt: vancomycin and may be with rifampicin
140. Moxifloxacin is quinolone
141. Moxifloxacin is quinolone
142. Most suitable oral sulfisoxazole is acetyl sulfisoxazole
143. Most important worm in children is Oxyuris (pin worm) ttt by mebendazole (as
ascaris ttt)
144. Most common SE of ketoconazole are: GIT disturbance and headache
145. MOA::: sulfonamides # growth by competitive antagonism --
cephalosporines,penicillins: # cell wall synth -- polymixin, nystatin, amphotricinB: # cell
membrane function ---macrolides, TC, chloramphenicol: # protein synthesis
146. MO which is dangerous to eye is Pseudomonas aeruginosa
147. Minocycline SE: giddiness (drowsiness), headache, abdominal cramps, allergic
reactions, CNS effect (vertigo, ataxia), discoloration of teeth, hepatotoxicity,
nephrotoxicity, N,V,D, vestibular toxicity (ataxia, dizziness, vomiting)
148. Metronidazole is used for ttt of anaerobic infections
149. Methicillin=pencillinase resistant
150. Methicillin is used in the ttt of staph, G+ve, used in upper respiratory infection??
-- only parentral not oral because of insatbility
151. Metabolism of PAS and INH by acetylation
152. Meningitis: N.meningitidis -- H. influenza -- strept. Pneumonia, E-coli
153. Medication used in methicillin resistant staph: vancomycin
154. Mebendazole is anthelmentic
155. Mebendazole is anthelmentic
156. Mantox test:: old tuberculin
157. LYME disease is caused by spirochetes borrelia carried by ticks --- symptoms:
rash, malaise, arthritis --- ttt: doxycyclin, TC - very severe: IV ceftriaxone
158. Lice can infest man , dog
159. Ketoconazole SE: GIT, headache, gynecomastia
160. Ketoconazole needs acid medium to be activated thus it is C.I. with famotidine
which dec HCl
161. Ketoconazole is only oral antifungal - amphotericin B : topical , injection
162. "ketoconazole is C.I W antacids, H2blockers, PPIs, cisapride, amphotricin B,
food.---
163. ketoconazole+ astemizole/terfinadine= life-threatening reaction"
164. Ketoconazole interact with warfrin
165. Ketoconazole can be administered orally
166. Ketoconazole can be administered orally
167. Ketoconazol SE: GIT, headache,?? Gynecomastia ??
168. Kanamycin is an aminoglycoside affect 8th cranial nerve
169. Kanamycin + FeSO4 = deafness due to damage of the 8th cranial nerve and
effect on auditory nerve function
170. K phospahte inc methenamine activity by dec pH of the urine
171. K content of K penicillin G is 1.7 m Eq/ million U
172. Isoniazide causes peripheral neuritis due to INH-induced pyridoxine deficiency
173. INH=isonicotinic acid hydrazine is the most potent anti-TB
174. INH is metabolized by acetylation
175. INH cause neuritis on prolonged use on slow acetylators
176. INH cause lactic acidosis (ttt by NaHCO3), pripheral neuritis (ttt by vit B6)
177. Infectious mononucleosis: is assossiated with high insidence of rash after
ampicillin injection
178. Impetigo: early vesicular lesions develop into bullae which quickly rupture
leaving thick yellowish crusts, multiple lesions of different ages are present, often on the
face and legs, staph. Aureus is responsible for 10-20% of impetigo cases esp. children

179. Impetigo: bacterial infection


180. Impetigo is contagious and caused by: staph. Aureus
181. Impetigo is a contagious disease caused by staph. Aureus - it does not cause
endocarditis
182. Impetigo cause all except endocarditis
183. Hydroxychloroquine is antimalarial used in SLE and rheumatoid arthritis, C.I in
favism
184. Hydroxychloroquine causes photosensitivity
185. High nitrite indicate bacteria in urine
186. Hansen: leprosy
187. Griseofulvin is taken after food
188. Griseofulvin is prepared in microcrystalline form to inhance solubility and
absorption
189. Griseofulvin is prepared in microcrystalline form to enhance its solubility,
absorption
190. Griseofulvin is prepared in a microcrystalline form to inc its solubility and
absorption
191. Griseofulvin is LME inducer so interact with OC
192. Griseofulvin is antifungal which is not used topically
193. Griseofulvin , nitrofurantoin are given after meals --- penicillins, tetracyclin,
rifampin are given before meals
194. Giardiasis ttt: metronidazole, quinacrine
195. Gentamicin is most effective against pseudomonas aerogenosa and against G-
bacteria in general
196. Gentamicin is active bactericidal against G-ve
197. Gentamicin is active against g-ve, E-coli, 1st choice against pseudomonas
auroginosa
198. Gentamicin causes deafness due to auditory and vestibular damage
199. Gentamicin (aminoglycosides) is more effective in alk urine ---nitofurantoin and
TC: more effective in acidic urine
200. Gantrisin: take with a large volume of water -- sulfonamides are taken with a
large volume of water to insure a volume of urine adequate to keep the excretory
products in solution. Crystaluria has occurred with some sulfonamides
201. Fluxacillin syrup must be refrigirated
202. Fluoxacillin=penicillinase resistant
203. Floxacillin syrup must be refrigirated
204. Fansidar (antimalarial) : sulfadoxime 400+ pyrimethamine 80 --- cotrimoxazole:
sulfasoxazole+ trimethoprime -- otitis media: erythromycin + sulfasoxazol
205. Expired tetracycline: fanconi-like syndrome
206. Erythromycin: would be a good alternative to penicillin V in a pregnant pt
allergic to penicillins. NOT: demeclocyclin, TC, trimethoprim
207. Erythromycin is taken as enteric coated tablets as it is destroyed by HCl of the
stomach
208. Erythromycin interacts with oral anticoagulants and inc levels of carbamazepine,
digoxin,theophylline
209. Erythromycin interact with: oral anticoagulants, carbamazepine, digoxin,
theophylline
210. Erythromycin inc the effect of aminophylline
211. Erythromycin does NOT affect the bioavailability of ketoconazole
212. E coli is the most common MO in complicate UTI
213. Drugs excreted by active tubular secretion = penicillin
214. Drug which is used in methicillin resistant staph: vancomycin
215. Drug used in anaerobic infections: metronidazole
216. Drug that would be most appropriate to treat gonorrhea in a poorly compliant
pt with a documented penicillin allergy: spectinomycin. NOT: amoxicillin, TC,
clindamycin, piperacillin
217. Drug of choice in H. influenza is ampicillin
218. Drug of choice for E-coli is co-trimoxazole
219. Drug of choice for E coli is cotrimoxazole
220. Drug effective against giardiasis: tinidazole
221. Doses:: erythromycin:0.25-0.5g qid
222. Dose of chloroquine in malaria: 500mg once weekly
223. Discarding of outdated tetracycline is important because: it changes to a more
toxic form
224. Dicloxacillin=penicillinase resistant
225. Degradation of penicillin is by hydrolysis
226. Common SE of chloramphenicol: aplastic anemia, gray baby syndrome
227. Common SE of chloramphenicol is aplastic anemia
228. Coadministration of kaolin with lincomycin cause impairment of lincomycin
absorption
229. Cloxacillin=penicillinase resistant
230. Clotrimazole, nystatin: ttt of candidiasis
231. Clotrimazole is bactericidal that # folic a` synthesis
232. Clostridium difficile: causes enteroclitis
233. Clindamycin: water soluble
234. Clindamycin is very sol in H2O -- not in ( alc, alc+propylene glycol)
235. Clarithromycin: macrolide antibiotic
236. Clarithromycin is active against : mycoplasma chlamydia, legionella, helicobacter
pylori
237. Ciprofloxacin: enzyme inhibitor: inc theophylline toxicity
238. Chloramphenicol SE: aplastic anemia
239. Chloramphenicol SE is aplastic anemia
240. Chloramphenicol is indicated primarily for typhoid fever
241. Chloramphenicol is a polymorphic drug
242. Chloramphenicol in infants leads to gray syndrom because of deficient
glucuronyl trasferase -- gray syndrome: cyanosis, vascular collapse, elevated
chloramphenicol levels in blood
243. Chlamydia: asymptomatic in females, dysuria in males
244. Ceftraixone, cefotaxime: cross BBB: ttt of meningitis
245. Caspofungin # asperagillus
246. B-lactamase is a plasmid mediated enzyme
247. Benzyl penicillin is used in pneumonia
248. Antitubercular drugs: isoniazide, streptomycin, PASA, rifampicin, BUT NOT
tobramycin
249. Antipseudomonal penicillins: carbenicillin, ticarcillin, mezlocillin, piperacillin
250. Antipseudomonal penicillins: carbenicillin, ticarcillin, mezlocillin, piperacillin
251. Antimicrobials: H2O2, isopropyl alcohol, phenol
252. Antibiotic induced ps. Colitis is ttt with vancomycin
253. "ANTHELMENTIC OF CHOICE: tape worm: niclosamide -- thread worm:
thiabendazole
a. pin worm, round worm: pyrantel pamoate -- whip worm, hook worm:
mebendazole"
254. Ampicillin suspention should be refrigirated 2-8 C but not freezed
255. Ampicillin suspension should be refrigirated
256. Ampicillin SE: diarrhea
257. Ampicillin is 1st choice in ttt of H.influenza
258. Amoxicillin is used in the ttt of otitis media
259. Amoxicillin + calvulenic acid = cholestatic jaundice and hepatotoxicity
260. Aminoglycosides cause damage to 8th cranial nerve
261. Aminoglycosides can be given once daily
262. Aminoglycosides are effective against pseudomonas infections BUT
chloramphenicol is NOT
263. Aminoglycosides are effective against pseudomonas infection BUT
chloramphenicol is not
264. Aluminium hydroxide iS C.I. with tetracyclines
265. Airborne grame +ve legionella pneumophila cause legionnaire's disease, ttt by
erythromycin
266. Advice for pt taking penicillin is take it 2hrs before food or on empty stomach
267. Acid-stable (oral) penicillins: ampicillin, amoxicillin, penicillin V
(phenoxymethylpenicillin), penicillin G Na and K salts
268. Acid stable (oral) penicillins: ampicillin, amoxicillin, penicillin V, penicillin G Na
and K salts
269. Achromycin V: don't take with milk or antacids -- milk and antacids reduce the
absorption of tetracycline by forming insoluble complexes
270. (cont.) of all the listed, erythromycin has the lowest degree of toxicity and the
spectrum of action most similar to ampicillin. Demeclocyclin and TC may # skeletal
growth in fetuses
271. (cont.) deposition of TC in the teeth of fetuses has been associated with enamel
defectscand staining of teeth. Trimethoprim is teratogenic
272. (cont. tobramycin) but damage may be continued even after the drug has been
discontinued. Dizzines, vertigo, tinnitus and hearing loss have been reported
273. (cont. spectinomycin) or may be given to pts who are allergic to penicillin & are
unable to tolerate or unlikely to comply with a 5-day TC regimen. It's given as a single 2-
gm IM injection and produce a cure in 90% of pts
274. (cont. spectinomycin) it's an aminocyclitol antibiotic related to the
aminoglycosides. While it's active against many G+, G- organisms, it's generally reserved
for ttt of gonorrhea in pts who fail ttt with penicillin, amoxicillin or TC;
275. (cont. mafenide) sulfamylon cr applied topically to burns has been found to be
quite effective in # invasion of the affected site by both G+ & G- bacteria, the cr is
usually applied to a thickness of about 1/16 inch bid over the entire burnt surface
276. (cont. AHA) the lowering of NH3 levels and PH enhances the effectiveness of the
antimicrobial agent with which it's used and inc the cure rate
277. (cont. AHA) some pts taking AHA have developed skin rash after drinking
alcohol. AHA chelates iron, which should not be taken concomitantly. It is available as
250-mg tablets
278. (cont. AHA) AHA also may prevent the formation of Staghorn renal calculi and
facilitate the dissolution of preexisting stones. It does not have an antibacterial effect,
nor does it acidify urine directly.
279. Nystatine: ttt of moniliasis (candida albicans)
280. Vancomycin causes ototoxicity
281. Rifampin and phenobarbital are CYP enzyme inducers
282. Nystatin is not absorbed from GIT
283. Metronidazole used in ttt of anaerobic peritonitis
284. Ciprofloxacin not to be taken with urine alkanizers
285. Case about cephalothin(v.easy) about 5 Q's
286. "Which of the following organism is responsible for the pseudomembraneous
colitis?A. Clostridium dificile
287. b. Clostridium tetani...c. Clostridium perfringes...d.Clostridium monocytogenes"
288. Drug used for bacterial Vaginosis?
289. What is the most appropriate advice for a patient who takes Metronidazole? a)
Do not take with grapefruit juice...b) Do not drink alcohol 24h before taking
Metronidazole...C) Take it with food
290. Longest half life: doxycycline
291. which of these medications causes acute renal failure?a) Vancomycin b)
Amphotericin B
292. Which cause of clostridium difficile- tetracycline - macrolides- cephalexin
293. What should Doxycycline not be taken with?a) Milk b) Iron supplements
294. tubular secretion will increase levels of : penicillin
295. Throat infection: streptococcus pyogenes
296. Tetracycline has an amphoteric structure
297. Tetracycline disadvanges:-aplastic anemia-Liver and kidney damage
298. Griseofulvine causes failure of which therapy (contraceptives)
299. Dapsone for leprosy
300. Which combination inh metabolism of other drugs (voriconazole + warfarin)
301. Vancomycin side effect: ototoxicity
302. Tolnaftate: antifungal- keratolytic-astringent-anti-inflamatory
303. Pseudomembranous colitis is caused by which bacteria? Which drug ???
304. Endotoxins released by bacteria causes increase in body temperature
305. Drugs in pregnancy that does not have enough studies? Ciprofloxacin-
Erythromycin-penicillin-Cephalexin
306. Cephalosporin dose adjustment is a must in .. Renal failure .. Liver failure… CHF
.. Pulmonary fibrosis
307. Cause of pertussis … garm +ve bacteria , gram -ve bacteria, anaerobic
308. Ampicillin activity is similar to amoxicillin
309. Whooping cough.........2 questions.
310. Which one is not a side effect of aminoglycosides?...Ans. Anaemia with
increased iron in blood. Because it is not affected by G6Pdeficiency
311. Which of these medications causes acute renal failure? a) Vancomycin b)
Amphotericin B
312. Which cause of clostridium difficile - tetracycline - macrolides - cephalexin
313. What should Doxycycline not be taken with? a) Milk b) Iron supplements
314. What is the most appropriate advice for a patient who takes Metronidazole? a)
Do not take with grapefruit juice b) Do not drink alcohol 24h before taking
Metronidazole C) Take it with food
315. Urinary infection.......drug of choice is augmentin....for women.
316. Tubular secretion will increase levels of : penicillin
317. Throat infection: streptococcus pyogenes
318. Tetracycline disadvanges: -aplastic anemia -Liver and kidney damage
319. Rifampicin monitoring.
320. Penicillin’s normal allergy. What antibiotics can be used?Ans: Cephalexin. If it is
anaphylactic then Beta-lactams must be avoided.
321. Penicillin v structure
322. Orally Unstable.....Ans. Nystatin
323. Oral antifungal treatment..... Ans. Fluconazole
324. Longest half life: doxycycline
325. Griseofulvine causes failure of which therapy (contraceptives)
326. Grandular fever.......which should not be used? Ans. Amoxycillin.
327. E.coli causes what? a) Endocarditis b) Appendicitis c) Traveler’s Diarrhea
328. Drug used for otitis media that has systemic involvement: amox, ticarcillin,
cefoxitin, erythro, cipro
329. Drug that worsens skin sunburns? Doxycyxline-ketocoazole-....
330. Drug of Choice for Cellulitis. Can’t take penicillin. What are the options?
.......Ans. Clindamycin
331. Dapsone for leprosy
332. Counselling use of antifungal pessaries and creams - what is wrong? a) Its
contraindicated in pregnancy b) excessive use can cause allergies c) if the course is not
finished the fungus might come back. d) if thrush happens often it can be a sign for
diabetes and needs to be checked by a GP
333. Clostridium Difficille infection related question
334. Clarithromycin related something
335. Chloramphenicol......... Renally cleared., so dose reduction is necessary.
336. Case profile. Patient is going to have dental surgery. Ans: Should be treated with
penicillin before surgery
337. Amphotericin causes wht?..........Ans. Decrease in K+ level.
338. Amino glycoside contraindicated with furesemide
339. Penicillin # transpeptidase enzyme so # bactreial cell wall synthesis
340. To kill spores heat at 100 C for 30 min in moist heat for 3 days
341. Drugs that interact with milk, antacids include tetracycline’s, cephalosporin
except erythromycin
342. Sulfa is not liable to decomposition by heat
343. Ketoconazole needs the presence of stomach acid for adequate absorption so
interact with famotidine
344. E.coli causes what?a) Endocarditis b) Appendicitisc) Traveler’s Diarrhea
345. Amino glycoside contraindicated with furesemide
346. Tubocurarine should not be taken in pts on gentamicin
347. Penicillin is recommended on empty stomach but not diazepam
348. Miconazole: antifungal -- glyburide: hypoglycemic
349. Linezolide : antibacterial, reversible nonselective MAOI, does NOT need dose
adjustment in renal failure also fosinopril does NOT need dose adjustment in renal
failure
350. Sulfonamides are metabolized by acetylation
351. INH, PAS, hydralazine, sulfonamides are metabolized by acetylation
352. B-lactams are metabolized by hydrolysis
353. Nalidixic acid + phenothiazines = phototoxic reaction
354. Counselling use of antifungal pessaries and creams - what is wrong?a) Its
contraindicated in pregnancy..b) excessive use can cause allergies ..c) if the course is not
finished the fungus might come back...d) if thrush happens often it can be a sign for
diabetes and needs to be checked by
355. Drug used for bacterial Vaginosis? Ketoconazole: ttt of systemic candidiasis --
ranitidine: ttt of peptic ulcer (PU) -- Na valproate: ttt of absence seizures -- theophylline:
ttt of asthma
356. Synovitis and ulcerative colitis are related inflammatory disease?? Diclofenac
and hydrocortisone are used
357. Sulfasalazine has poor absorption from the GIT, used for ttt of ulcerative colitis,
regional enteritis

Anti-coagulants recalls

1. Warfarin, dicumarol both have coumarine structure thus have anticoagulant activity
2. Warfarin toxicity: skin necrosis and purple discoloration of the toes, hemorrhage, ttt by
vit K
3. Warfarin MOA: interfare with vitamin K dependant synth of active clotting factor II
(prothrombin), VII, IX, X, and the anticoagulant protein C, S (these agents prolong
clotting time in vitro only ), warfarin has optical isomers
4. Warfarin is safe to be taken with allopurinol
5. Warfarin is active due to a specific sterioisomer
6. Warfarin has optical isomers
7. Warfarin can be used in different therapeutic forms because it has optically active
centers
8. TXA2 induce platelet aggregation
9. Tranexamic acid, aminocaproic acid and aprotinin are all antifibrinolytic
10. The PT of pts on antocoagulant therapy with coumarin or phenindione derivatives will
be decreased by: vit K. PT: the time it takes for fibrin to gel in plasma after addition of Ca
and thromboplastin.
11. The initiation of therapy with chlorpheniramine maleate would be least likely to cause
therapeutic problems in pts already taking warfarin because it will not displace warfarin
from it plasma protein binding sites
12. Streptokinase: 1.5 million IU (IV inf) over 60 min
13. Streptokinase not given within 6 months from previous administration due to allergy
(antibody-antigen reaction)
14. Streptokinase is given IV, never IM to avoid hematoma
15. Streptokinase is contraindicated ib pt with peptic ulcer
16. Streptokinase in pts receiving simultaneous ttt with platelet aggregation inhibitors, e.g.
aspirin, phenylbutazone, dipyridamole, and NSAIDs, for elderly pts should not be
repeated within 12 months of last course
17. Sodium Heparin USP should always be ordered in units rather than mg because: the use
of standard units/ml of preparations gives a more reproducible dose. Heparin is not a
uniform molecular species, therefore, should be prescribed in units rather than mg
18. Pt takeing warfarin should avoid phenylephrine as it is alpha agonis thus increase
platelet aggregation
19. Protamine sulfate is antidote for heparin
20. Platelet aggregation inhibitors: cefotetan, cefoperazone, cefamandole, moxolactam,
ketorolac
21. Normal prothrompin time: 12-15 seconds - APPTT: 30-45 seconds
22. Na heparine is obtained from beef lung
23. MOA of warfarin: inhibit vit K epoxide reductase
24. In treating excessive heparin with protamine sulfate, caution must be exercised to avoid
more protamine than is necessary because protamine sulfat is anticoagulant, it is
unadvisable to give more than 100mg over a short time unless there's a definit need
25. If a pt receiving heparin suffers from gum bleeding: should be advised to wait until
action of heparin subsides
26. If a pt on oral anticoagulant therapy experiences mild to moderate bleeding, the
desirability of administering vit K should be weighed against the underlying need for the
naticoagulant therapy because with use of vit K will make it much more difficult to:s
27. Hypoprothrombinemia: dec ability of blood to clot -- to reverse hypoprothrombinemia:
adm. Fresh blood plasma
28. Heparin is the anticoagulant of choice in pregnancy because it does not cross the
placenta
29. Heparin is anticoagulant of choice in pregnancy; it inhibits conversion of prothrombin to
thrombin
30. Heparin is administered SC
31. Heparin delay thrombin formation??
32. Heparin anticoagulant activity is monitored by activated partial thromboplastin
time(APTT)
33. Coumadin: do not use aspirin without knowledge of your physician or pharmacist
34. Clofibrate dec platelet aggregation, inc hepatic cancer
35. Chlorpheniramine maleate can be used safely with warfarine
36. Aspirin should not be taken with coumarin
37. Aspirin should NOT be taken with coumarin
38. Aspirin inhibit platelet aggregation
39. Anticoagulant of choice for use in pregnant pt near the time of delivery: heparin, it is a
high molecular weight mucopolysaccharide that does not cross the placenta-
prothrombin time in mother should be closely monitored to dec the risk of fetal
hemorrhag

40. Aminocaproic acid, tranexamic acid: antifibrinolysin used in toxic doses of streptokinase,
alteplase (fibrinolytic agents)
41. Aminocaproic acid is used as antifibrinolytic agent , ttt of hemmorrhage due to
fibrinolytics
42. Alteplase is thrombolytic agent
43. (continue PT) the PT of pts on coumarin drugs is prolonged because of the reduced
activity of several blood factors. Vit K antagonizes the action of these anticoagulants and
therefore shortens PT
44. (continue protamine) protamine is a strongly basic substance that combines with the
strongly acidic heparin to produce a stable salt and loss of anticoagulant properties
45. (continue oral anticoagulant versus vit K) retitrate the pt on the oral anticoagulant. The
adminstration of vit K1 (phytonadione) will correct oral anticoagulant-induced bleeding
within a few hours.. This should be only in severe hemorrhage cases
46. (continue heparin) the old equivalence of 100mg=10000U is a poor approximation
because the USP specifies the potency to be not less than 120U/mg when derived from
lung tissue and not less than 140U/mg when derived from other tissues
47. (continue heparin) potency shoukd be 90-110% of what is stated on the label. If the
physician orders 100mg of heparin, it is not clear whether he means 10000 or 12000U or
some other quantity
48. (cont. warfarin interactions) but drugs like: phenylbutazone, indomethacin, aspirin,
tolbutamide have high affinity for plasma protein binding, so cause therapeutic
problems with warfarin
49. Question about coagulation factors? Thrombin- fibirin- need Ca ions-...
50. Advantages of LMW heparins compared with unfractionated Heparins. Which one does
not apply?a) Less osteoporosis..b) Less HIT…...c) Same Method of checking..d) Longer
Half life.e) can be given i.m.
51. Warfarin interacts with voriconazole
52. Warfarin is optical isomer
53. Question about coagulation factors? Thrombin- fibirin- need Ca ions-…
54. Monitoring of Heparin............Ans. APTT
55. Heparin overdosing? What should be used?Ans: Protamine
56. Advantages of LMW heparins compared with unfractionated Heparins. Which one does
not apply? a) Less osteoporosis b) Less HIT c) Same Method of checking d) Longer Half
life e) can be given i.m.
57. Which of the following will increase warfarin activity?a. paracetamol ..b. esomeprazole
58. Drug interactions related to Simvastatin, warfarin, CCB.
59. Remove Ca ions, add citrate salts to prevent blood clotting taken from volunteer
60. Chlopheniramine maleate, allopurinol can be given safely with warfrin

Anxiety recalls

1. Phenobarbitone Na + chloramphenicol= pptn of barbituric acid


2. Na phenobarbitone + chloamphenicol = pptn of barbituric acid
3. Zolpidem: fast onset, short duration hypnotic
4. Triazolam (short acting benzodiazepine) : hypnotic in elderly
5. Thiopental is highly lipid soluble that is cross BBB
6. Thiopental = ultrashort acting barbiturate
7. Temazepam: it is metabolized to inactive metabolite in the liver by glucuronidation.
Temazepam is metabolized pricipally in the liver where most of the drug is directly
conjugated to the glucuronide and excreted in the urine ???
8. Temazepam: it is metabolized outside the liver (OTL) to active oxazepam
9. Sleep aids: melatonine, tryptiphan (in milk), doxylamine, diphenhydramine
10. Short acting benzodiazepines: alprazolam, lorazepam, temazepam, zolpidem, oxazepam,
triazolam:: are used with elderly pts
11. Phenobarnitone is a metabolite of primadone
12. Phenobarbitone Na ( basic ) may ppt in urine
13. Phenbarbitone is metabolized in liver by CYP450 then oxidation then conjugation
14. Normal hypnotic dose of chloral hydrate= 3-2 gm
15. Nitrazepan= have a t1/2 of 30 hrs produce long daytime sedation which should be
avoided in the elderly to avoid falls , fractures due to accumulation of nitrazepam
sedative effects
16. Nitrazepam is not used for the ttt of insomnia in elderly pts but we can use oxazepam,
lorazepam
17. Nitrazepam has t1/2=25-35 hr. produce long daytime sedation which should be avoided
in elderly pt to avoid falls and fractures due to sedative effect
18. Nirtrazepam is NOT use in the ttt of insomnia in elders
19. Na phenobarbital ( enzyme inducer ) affect OC
20. Mechanism of GABA: inhibitory neurotransmitter acting on:: GABA A inc Cl conductance
-- GABA B presynaptic: dec Ca conductance, postsynaptic: inc K conductance
21. Lorazepam is the most suitable night sedative for elders
22. Lorazepam is a BZD which is preferred to be used as anxiolytic drug for elderly pt with
history of cirrhosis
23. GABA is inhibitiry neurotransmitter in brain
24. Flurazepam: longest duration benzodiazepine (BZD)
25. Flurazepam is the benzodiazepin which has the least hypnotic effect and cause hangover
sedation as SE
26. examples of benzodiazepines: triazolam, flurazepam, alprazolam, temazepam,
lorazepam-- flurazepam have FDA approval for use as a hypnotic but its least effective
for this purpose and the most likely to cause hangover sedation.
27. Drug-induced neonatal jaundice can be ttt with: phenobarbital. Although exchange
transfusion have traditionally been used to manage hyperbilirubinemia, this ttt rarely
dec the bilirubin to even 1/2 of its pretransfusion level and exposes the neonate
28. Diazepam is different from temazepam in that diazepam has longer duration of action
than temazepam
29. Carbamazepine induce its own metabolism on long term use
30. Buspirone is antianxiety agent, it has very few sedative, muscle relaxant and
anticonvulsant effect
31. "Benzodiazepines preferred as anxiolytic drugs for an elderly pt with a history of
cirrhosis:
32. lorazepam, oxazepam (NOT: chlordiazepoxide, diazepam, chlorazepate, prazepam)"
33. Barbiturates:::: long acting: phenobarbital -- intermediate: amobarbital, butabarbital --
short: pentobarbital, secobarbital -- ultrashort: thiopental
34. Barbiturate metabolism: oxidation the conjugation with sulfate
35. Anxiolytic drug with least sedative action: buspirone
36. (cont. phenobarbital vs. n.jaundice) to the hazards of blood transfusion. More recently,
phenobarbital have been found to be effective in lowering serum bilirubin levels, it
enhances glucuronidation by stimulating syn of LME,
37. (cont. phenobarbital vs. n.jaundice) complete failure of this ttt can probably be
attributed to discontinuing of the drug prematurely
38. (cont. phenbarbital vs. n.jaundice) and by inducing production of bilirubin-binding Y
protein. The dosage is 5mg q8hrs (beginning 6-8hrs after delivery) for 3-5days until
serum bilirubin level falls below 10mg/dl.
39. (cont. lorazepam, oxazepam) resulting in drug accumulation and the risk of
oversedation. Lorazepam and oxazepam are metabolized by glucuronidation which is
much less dependant on liver function than is oxidation, moreover the metabolites are
inactive
40. (cont. lorazepam) chlodiazepoxide, diazepam, chlorazepate, prazepam all are
metabolized in the liver by oxidation to desmethyldiazepam, an active metabolite with a
very long half life, this process is impaired in the elderly (cirrhosis)
41. (cont. hypnotics) fluorazepam is metabolized to an active metabolite
(desalkylfuorazepam) which has an extremely long t1/2 (>100hrs). Fluorazepam require
several nights to become maximally effective
42. (cont. hypnotics) and fluorazepam often cause morning after effects
43. (cont. hypnotics) although all of the benzodiazepines have dose-related hypnotic
effects, only fluorazepam, temazepam, lorazepam & triazolam are FDA approved for this
indication. Triazolam has a very short t1/2 (2-3hrs)
44. (con. Hypnotics) lorazepam and temazepam have intermediate t1/2 (10-15hrs) all three
are rapid acting drugs that are unlikely to cause morning after effects.
45. Midazolam.........Ans. Used for Anaesthesia.
46. In Bipolar, which drugs are not used. Ans. Benzos because it increases GABA
47. Diazepam in normal saline= ppn of diazepam- diazepam soln: 70%H2O+10%+PEG20%

Arrhythmia recalls

1. Tocainide (antiarrythmic) SE: pulmonary fibrosis, blood dyscrasias


2. Terfenadine , astimazole + ketoconazole = life treatening arrythmia
3. Sotalol: monitor CrCl
4. Sotalol B-blocker antiarrythmic causes torsades de pointes
5. SA node=the pacemaker of heart
6. Qunine sulfate relieve night cramps
7. Qunidine replace digoxin from plasma protein binding sites causing digoxin toxicity
8. Quinine SE is cinchonism
9. Quinine is an optical isomer to quinidine
10. Quinine inc plasma level of digoxin, inc toxicity
11. Quinidine makes digoxin level inc 2-2.5 folds due to # of metabolism and displacement
from tissue binding sites in pts previously stabilized on digoxin, dose of digoxin should
be halved when adding quinidine -- and pt should be monitored for toxicity
12. Quinidine is optical isomer of quinine
13. Quinidine inc levels of:: digoxin, warfarin, nifedipine, haloperidol, procainamide
14. Quinidine inc digoxin level
15. Procainamide is DOC for AVRT= atrioventricular reinterent tachycardia
16. Pacemaker of heart is SA node
17. Order of impulse: SA node - AV node - bundle of His - Purkinge
18. Na lactate dec toxicity of quinidine
19. Lignocaine is not taken orally due to 1st pass effect
20. Lignocaine is given IV to avoid oral first pass effect
21. Lidocaine SE: malignant hyperthermia, CNS toxicity, tinnitus, blurred vision, parathesia,
tremor, dizziness, disturbed hearing
22. Increase QT interval elevation: cisapride, ketoconazole (azoles), phenothiazine,
quinolones
23. In CHF pt we should adjust the dose of lignocaine because of decreased blood perfusion
of liver so decreased metabolism of lignocaine
24. Digitalis does not treat ventricular arrythmia
25. Cisapride + ketoconazole = prolong QT
26. Bundle of HIS is present in heart
27. Amiodarone cause: pulmonary fibrosis, yellow deposits on cornea, skin deposits, change
in color, CNS effects, thyroid dysfunction, photosensitivity
28. Amiodarone cause photosensitivity
29. Amiodarone cause occular, sight problems
30. Amiodarone cause occular and sight problems
31. Amiodarone antiarrhythmic causes occular, sight problems
32. Adam- Stoke's disease or syndrome disease is caused by heart block. It is characterised
by sudden attacks of unconsciouness, sometimes with convulsions
33. Quinine is an isomer of quinidine
34. Which medication is used to control Arrhythmias secondary to MI..a) Atenolol..b)
Verapamil..c) Nitrates
35. Which medication is used for arrhythmia, hypertension and Angina?a) Verapamil..b)
Nifedipine..c) Amlodipine
36. Question abt Amiodarone
37. Which medication is used to control Arrhythmias secondary to MI a) Atenolol b)
Verapamil c) Nitrates
38. Which medication is used for arrhythmia, hypertension and Angina? a) Verapamil b)
Nifedipine c) Amlodipine
39. Systole mean that ventrical contraction
40. Quinine and quinidine … isomers

Asthma recalls

1. Erythromycin + aminophylline= inc level of aminophylline so dec aminophylline dose by


25%
2. Zileuton: # 5-lipoxygenase
3. Zafirlukast # slow-reacting substance that causes anaphylaxis (SRSA)
4. Zafirlucast, montelukast: LT receptor antagonists
5. Types of respiratory volumes: tidal vol, minimum vol, max vol
6. Thyophylline atidote: B-blocker
7. Theophylline SE: nausea, vomiting, anxiety, tachycardia
8. Theophylline SE : NV, anxiety, tachycardia, tremors
9. Theophylline is C.I. with cimetidine
10. Theophylline is C.I. with cimetidine
11. Theophylline by slow IV infusion
12. Theophylline + ethylene diamine = aminophylline
13. Theophyllin should be 10-20 mg/L
14. Theophyllin is potentiated by erythromycin , O.C , cimetidime , ceprofloxacine ,
influenza vaccine - inhibited by rifampin , carpamazepine , phenytoin
15. The respiratory volume: the respiratory air and expiratory air
16. Terbutaline is a beta2 agonist used in acute attacks of asthma
17. Terbutaline is a B2 agonist
18. Sod. Chromoglygate: mast cell stabilizer used for asthma prophylaxis
19. Salmeterol: long acting B-agonist but slow onset --- albuterol: rapid acting, short
duration
20. Salbutamol, acute asthma -- Na chromoglycate: allergic asthma -- corticosteroids,
seasonal asthma
21. Salbutamol is used before inhalation of betamethasone by 10 min
22. Salbutamol can lower blood pressure
23. Salbutamol + terbutaline = not logic combination for asthma
24. Respiration value is determined by vital capacity
25. Ragweed allergy: avoid pyrethrins
26. Phenytoin: dec theophylline --- interferone: inc theophylline 100%
27. Oral prednisolone is NOT give to a child with chronic asthma BUT he is given inhaler
prednisolone or long acting theophylline
28. On asthma c-AMP is decreased
29. Normal adult dose of salbutamol is 1-10 mg
30. Na chromoglycate is used for seasonal allergy as mast cell stabilizer
31. Na chromoglycate does NOT cause direct bronchodilation
32. MOA of methylxanthines: # phosphorylase which converts active 3,5c-AMP to
inactive5c-AMP thus inc c-AMP --- catecholamines also inc 3,5c-AMP BUT by activation
of adenylcyclase
33. Major respiratory volume is determined by vital capacity
34. Major respiratory volume is determined by vital capacity
35. Long residence of CO2 in body= inc pCO2 (hypoventilation)= dec HCO3=lactic acidosis
36. IV infusion of aminophylline is given in: acute asthma case
37. Inc pCO2 in blood:: most potent respiratory stimulant
38. Inc P CO2 is the most potent respiratory stimulant
39. In emergency room the preferred first line therapy of asthma is B agonist
40. In asthma::: TLC, FRV, RV, WBC inc --- FEV dec
41. In asthma there is no increase in cAMP
42. In asthma c-AMP does not increase
43. In 10 year old child, which one should be used long term? Answer: prednisolone tab.
Not predisone inhaler or theophylline (can be used)
44. Drugs that could be given in acute asthma: salbutamol, albuterol, terbutaline
45. Doxapram: resp. stimulant in COPD, inc depth of respiration, DOESNOT inc rate of
respiration
46. Cromolyn Na is given in: prevention of execise induced asthma -- unstable orally
47. Corticosteroids in asthma inhibit release of mediators, dec immune reaction
48. Corticosteroids are used in asthma as antiinflammatory decongestants
49. Corticosteroids action in asthma:: dec inflammatory response and dec airway
hyperresponsiveness
50. Corticosteroids action in asthma is antiinflammatory and dec airway
hyperresponsiveness
51. Chromoglycate: inhibit the release of mediator and cause bronchial relaxation
52. Carboxymethylcysteine is mucolytic and dec mucous membrane hyperplasia
53. B-bloclers C.I. with asthmatic pts.
54. B-blockers are C.I. in asthma
55. Aspirin asthma sensitivity is due to decreased prostaglandin synth and increased
leukotriene synthesis
56. Aminophylline is theophylline ethylenediamine
57. Aminophylline is a theophylline derivative better to be used rectally
58. Allopurinol, alcohol, propranolol, cimetidine: inc theophylline
59. Counseling for usage of inhaled MDI
60. Which used to treat allergic rhinitis - diphenhydramine - cetirizine-pseudoephedrine
61. What used as preventer in asthma?-antihistamine-beta agonist-anticholinergics-
glucocrticoides
62. What change in theophylline dose with ciprofloxacin - increase dose of theophylline by
50%..-decrease dose of theophylline by 30%...- increase dose of ciprofloxacin 50%..-
decrease dose of ciprofloxacin 50%
63. Which one is not a preventer in asthma? Terbutaline
64. Theophylline increases by Ciprofloxacin
65. Propranolol contraindicated in asthma
66. Formetrol onset of action: 10 to 20 minutes
67. Dyspnoea meaning shortness of breath
68. Asthma causes Increase in airway resistance
69. Which used to treat allergic rhinitis - diphenhydramine - cetirizine -pseudoephedrine
70. What used as preventer in asthma? -antihistamine -beta agonist -anticholinergics -
glucocrticoides
71. What change in theophylline dose with ciprofloxacin - increase dose of theophylline by
50% -decrease dose of theophylline by 30% - increase dose of ciprofloxacin 50% -
decrease dose of ciprofloxacin 50%
72. Propanolol should be avoided with asthma patients
73. Dose of Hydrocortisone in COPD.
74. Counseling for usage of inhaled MDI
75. Asthma.......is wht?
76. Theophylline conc. in the body decreases by smoking-ciprofloxacin
77. Asthma can be triggered by all of the foll. Except … Aspirin.. St. Jones wart…Royal jelly
78. Na cromoglycate is used for seasonal allergy
79. Oxidation of ethylene glycol gives oxalic acid -- metabolism of ascorbic acid gives oxalic
acid

Autacoids recalls

1. Sumatriptam mimic the serotonin action - C.I. in: CHF, angina, MAOIs
2. Ritodrine: tocolytic, # oxytocic, relax uterine muscles
3. Prostaglandines group is related to fatty acids
4. Promethazine is antihistaminic, antimotion sickness
5. Promethazine is a potent antimetic, it is also antihistaminic, it is a phenothiazine
derivative
6. PG are group of related fatty acids
7. Pentoxyphylline: hemorrheological, dec blood viscosity, antiplatelet --- ttt of cold
extremities, Reynold's disease
8. Migraine is due to celebral vasodilation
9. Methylsergide: serotonin antagonist in brain
10. Hydroxyzine: anxiolytic with high antihistaminic action
11. Hydroxyzine is an antianxiety antihistaminic
12. Hydroxyzine has the greatest anthistaminic action (of all anxiolytic drugs)
13. Histamine: cardiac stimulation
14. Examples of sublingual drugs : nifedipine , ergotamine tartarate not maleate
,nitroglycerine , isosorbid , captopril
15. Ergotamine ttt of migraine ---- ergometrine = oxytocic
16. Ergotamine tartarate and nitroglycerine can be used sublingually
17. Ergotamine causes vasoconstriction
18. "Ergot alkaloids are used in migraine and prevention of post partum hemorrhage by
19. stimulation of uterine contraction"
20. Ergot alkaloids are used and migraine and prevent post0partum hemorrhage by
increasing uterine contraction
21. Ergot alkaloids are are used in migrain and also used as oxytocics
22. Ergometrin is NOT taken sublingually
23. Dose of viagra 50mg 1hr before intercourse (range is 25-100 once daily)
24. Dihydroergotamine is not taken sublingually (IV) but ergotamine tartarate is
takensublingually and orally
25. Cyproheptadine is antihistaminic drug with serotonin antagonist and Ca channel
blocking property
26. Cyproheptadine is antihistaminic / anti 5HT
27. Cetrizine does NOT cause nausea
28. Cetrizine does not cause nausea
29. Azatadine SE = drowsiness
30. Azadatine: antihistamine that causes drowsiness
31. Astimazole: 2nd generation antihistamine, does not cause drowsiness -- astimazole,
terfenadine + ketoconazole=life threatening arrhythmia
32. Antihistaminics= cyclizine , promethazine, chlorpromazine, diphenhydramine
33. Alprostadil is for patent ductus arteriosus in neonates ??
34. "Which of the following is not to be given in pregnancy?which of the following is not to
be given in pregnancy?
35. The option was dinoprost and other drugs"
36. "What is the dose for Viagra (sildenafil):a. initiate dose with 25 mg one hour before
sexual activity
37. b.initiate dose with 50mg one hour before sexual activity c. take 100mg once a day d.
take 20 mg 4 times a day"
38. Sumatriptan is used for which of the following migraine condition?a. migraine headache
with aura..b. migraine headache without...c .migraine with cluster headache
39. What is the dose of Sildenafil?a) 25mg 1h before intercourse b) 50mg 1h before
intercourse c) 100mg 1h before intercourse d) 200mg daily max.
40. Which is not used in migraine prophylaxis…. Ergot, propranolol, pizotifen, clonidine.
41. Which is not true for cyproheptadine (in relation to migraine, very weird options: used
in epilepsy, cns vasoconst veins)
42. What is the dose of Sildenafil? a) 25mg 1h before intercourse b) 50mg 1h before
intercourse c) 100mg 1h before intercourse d) 200mg daily max.
43. Migraine...........2 questions
44. Ergotamine tartarate sublingual - ergotamine maleate is not sublingual
45. Alprostadil is used in ductus arteriosus

Autoimmune recalls

1. Sulfasalazine metabolized to 5-aminosalicylic acid


2. Sulfasalazine is used in rheumatoid arthritis and for ulcerative colitis (Crohn disease
3. Psoriatic arthritis: inflammation of skin, joints, eye, heart, lung, kidney, systemic
rheumatic autoimmune, ttt: NSAIDs, MTX, corticosteroids, antimalarial??
4. Psoriasis: silvery gray scales
5. Psoriasis does not cause endocarditis
6. MTX is considered immunosuppressant
7. Methotrexate + salicylate = BMD
8. Goeckerman : cooltar + UV (for ttt of psoriasis)
9. Drugs used for psoriasis: MTX, cool tar 2%, salicylic acid
10. Dithranol dose: 0.1-1% (psoriasis)
11. Dithranol 0.1% : for psoriasis ttt topically is better stabilized in ZnO pastes by addition of
2% salicylic acid
12. Ditharol 1% is used fir ttt of psoriasis
13. Disease related to destruction of myeline sheath is multiple sclerosis (MS) ??
14. Cyclosporine: immunosuppressant
15. Cyclosporine: immunosuppressant
16. Cyclosporine: cyclic polypeptide immunosuppressant - nephrotoxicity in 25-30% of pts,
synergism with other nephrotoxic drugs may occur, HTN, hirsutism, gum hyperplasia
17. Cyclosporine may be administered concurrently with adrenal corticosteroids BUT NOT
with other immunosuppressive agents
18. Cyclosporin oral soln (100mg/ml) is drunk immediately after mixing with milk, chocolate
milk or orange juice an IV dosage form is also marketed
19. Butazolidin: take with milk, antacids or meals to decrease gastric irritation
20. Psoriasis cha by silvery scales
21. Methotrixate antidote is folinic acid
22. Patient on methotrexate perfusion, to prevent toxicity from happing he should take folic
acid with methotrexate
23. Lupus: butterfly rash
24. Methotrexate mechanism of action: Folate reductase inhibitor
25. Lupus: butterfly rash
26. Psoriasis ttt: methotrexate
27. Psoriasis is characterized by silver , grey scales -- red macule, papule or plaque covered
by silvery lamellated scales -- scalp, elbows, knees, shins are usually affected first
28. Multiple scelerosis (hypersensitivity type III) ttt: interferon B 1a/1b, baclofen,
dantrolone
29. Methotrexate is effective in the ttt of psoriasis
30. Silvery scales in Psoriasis is due to increased keratinocytes

Autonomic recalls

• Urine determinations of catecholamines and their metabolites are useful in diagnosis of


pheochromocytoma
• Thirst is controlled by hypothalamus
• The ester group in atropine is liable to destruction
• The ester group in atropine is liable to destruction
• Terbutalin has less cardiac SE than isoproterenol
• Sympathomimetic long term use causes hypertension
• Sympathetic ganglia are located near the spinal cord
• Sympathetic ganglia are located near spinal cord
• Suxamethonium is succinylcholine ??
• Suxamethonium is short acting depolarizing skeletal muscle relaxant
• Suxamethonium is short acting depolarizing seletal muscle relaxant
• Suxamethonium is a short-actine skeletal muscle relaxant ( depolarizing )
• Succinylcholine should be taken with caution in pts taking phospholine
• Slow IV of adrenaline: inc cardiac output, not diastolic bl pressure
• Slow IV infusion of adrenaline: inc cardiac output NOT diastolic blood pressure
• Senokot is a selective neuromuscular stimulant of the colon, restoring normal rythmic
motility
• Pt taking pargyline when prescribing cold remedies to him avoid: phenylephrine HCl,
BUT NOT: chlopheniramine maleate, aspirin, caffeine, acetaminophen
• Pt about to undergo ECT (Electroconvulsive therapy) is usually given succinylcholine
• Pralidoxine leads to regeneration of cholinesterase after organophosphorus poisoning
• Pheochromocytoma ttt : mixture of alpha and beta blockers
• Phenylephrine has no diuretic effect
• Phentolamine: diagnostic agent for pheochromocytoma
• Parathion and malathion are organophosphorus compounds and act as irreversible
anticholinesterases
• Parasympathomimetics are used in glucoma
• Organophosphorus compounds irreversibly block cholinesterases
• Organophosphorus compounds act by irreversible inhibition of cholinesterase
• On long term use of sympatholytics= hypotention may occur
• Nylidrin is useful as vasodilator
• Norepinephrine acts on postganglionic sympathetic receptors on the effector organs
mainly or presynaptic receptors on the nerve endings
• Neostigmine does NOT cross the BBB - physostigmine cross BBB
• Neostigmine does not cross BBB but physostigmine crosses BBB
• Myathenia gravis: antibodies against nicotinic receptors on skeletal muscles plasma
membranes at NMJ act as a competitive antagonis to Ach binding
• Myasthenia gravis is characterised by fatigue and exhaustion of muscles. Although
progressive paralysis of muscles occurs, there are no sensory effects or atrophy
• Meprobamate is skeletal muscle relaxant
• Mecanism of action of methyl xanthines: # phosphorylase which convert 3,5 c-
AMP(active) to 5cAMP(inactive) so inc c-AMP ---MOA of catecholamines: also inc
3,5cAMPBUT by activation of adenylcyclase
• Malathion: irreversible choliesterase
• Malathion is organophosphorus compound
• Malathion is an organophosphorus compounds
• M.O.A. of B agonist: inc c-AMP by activation of adenylcyclase
• L-isomer of adrenaline is 20 times more active than D-isomer --- L isomer of atropine is
100 times more potent than D isomer
• L-hyoscyamine (atropine) is 100 times more potent than D isomer
• Levarterenol=L-norepinephrine
• Labitolol is alpha and beta blocker
• Labetalol is non selective adrenergic antagonist
• Isoproterenol is B agonist
• Hyoscine is a muscarinic antagonist
• Glutamic acid by decarboxilation is converted to GABA
• Glutamic acid (+ glutamic acid decarboxylase + vitamin B6) = GABA ---- deficiency of
vitamine B6 : dec GABA, inc glutamic acid
• Function of vagus:: regulate heart rate
• Function of vagus: regulation of heart rate
• Ephedrine is the least desirable B-agonist in the ttt of bronchial asthma because it is
nonselective
• Edrophonium is used in the diagnosis of myasthenia gravis
• Edrophonium is used in diagnosis of myathenia gravis ( M. gravis )
• Edrophonium is used in diagnosis of myathenia gravis
• Dose of atropine: 0.2-2 mg
• Demecarium is a long acting anticholinesterase used to treat primary open-angle
glaucoma, glaucoma in aphakia, and accommodative estropia
• Dantrolene: centrally acting skeletal muscle relaxant -- SE: seizures --- baclofen,
orphenadrine, cyclobenzaprine: peripherally acting skeletal muscle relaxants
• Cyclic AMP is a 2ry messenger NOT a mediator in CNS
• COMT does NOT metabolize isoprenaline
• COMT does not metabolize isoprenaline
• Competitive inhibitors cause less enzyme inhibition that non competitive inhibitors
• CNS mediators: acetylcholine, serotonin, dopamine, noradrenaline BUT c-AMP is not
• Cholinergic crisis may resulr fro M. gravis ttt
• Cholinergic crisis may occur in myasthenia gravis
• Cholinergic crisis may be observed in M. gravis
• Cholinergic crisis causes parkinsonism??
• Carbachol is cholinergic agonist
• Carbachol is a cholinergic agent
• Bethanechol is similar in action to acetylcholine
• B-agonists (adrenaline- like )= stimulate adenyl cyclase so inc cAMP so inc Ca entry to
myocardial cells = positive inotropic action
• Atropine SE : dry mouth, blurred vision, constipation, tachycardia
• Atropine is sol in acids
• Atropine is antidote for anticholinesterase amd selectively block muscarinic receptors
• Atropine is antidote for anticholinesterase
• Atropine cause hemodynamic alterations as it causes initial tachycardia
• Atropine cause hemodynamic alteration as it cause initial bradycardia
• Atropine blocks muscarinic receptors of acetylcholine
• Atropine + pralidoxine is used for ttt of organophosphorus poisoning
• Atropine (d,l hyoscyamine is more potent than d-hyoscyamine) (L isomer is 100 times
more potent than D isomer
• Appropriate stimulation of sympathetic nerve: contraction of vascular smooth muscles
• Anticholinesterase act by structural similarity to acetylcholine
• Anticholinergic SE (family of atropine): dry mouth, dec sweating, dec acid
secretion,constipation, hypotension, urinary retention, in IOP (C.I. with glaucoma),
dizziness, anxiety,hallucination but don't cause insomnia
• Alpha receptors: constriction of arterioles
• All the following drugs are used to treat open angle glaucoma carbachol, physostigmine,
neostigmine, demecarium
• Advantage of usage of dopamine in cardiogenic shock is that it produce dose dependent
in cardiac output and renal perfusion
• Adrenaline is metabolized by MAO
• Adrenaline injection strength is 1:1000 mg/L
• Acetyl + CoA + ATP = acetyl CoA + ADP ------ acetyl CoA + choline + cholinesterase
=acetlycholine
• (cont. succinylcholine vs. phospholine iodide) the enzyme responsible for the
metabolism of succinylcholine, the action of succinylcholine is enhanced in pts taking
this combination, thereby possibly causing apnea and death
• (cont. pargyline and phenylephrine) phenylephrine is an adrenergic stimulant which is
normally metabolized in the liver by MAO. In the presence of a MAOI such as pargyline,
accumulation of phenylephrin, toxically, elevation of pt's blood pressure
• Somatic nerve is not included in the ANS
• Increase tone of vagal nerve doesn't cause vomiting
• Dobutamine acts via B receptor agonism
• Atropine dose
• Acetyl choline is choline ester
• The following molecule is:a. Precursor of dopamine b. Dopamine c. NE d. ????? sorry
don’t know Ans as this is the levo dopa molecule we should be able to understand that
it is the precursor of dopamine
• Organophophorous poison: parathion
• In anticholinesterase poisoning, first give: pralidoxime
• Damage of protein and peptides due to:-deamination-oxidation
• Tubocurarine mechanism of action: blocks postsynaptic ganglia
• Sympathomimetic actions except which one? Increased gastric motility
• Atropine intoxication (symptoms and find exception)
• Ach poisononing symptoms except which one? Mydriasis
• Tubocurarine MOA: compet antag
• Sympathetic/parasympathetic question
• Suxamethonium (asked twice) why some people have different response to it…
alteration in pseuedocholinesterase enzyme
• Organophophorous poison: parathion
• Neostigmine ADR
• Labetalol MOA
• In anticholinesterase poisoning, first give: pralidoxime
• Doses: atropine
• Cholinergic Side effects........which one is not?
• Atropine toxicity.............
• Succinylcholine should be administered with extreme caution to pts being treated with
phospholine iodide. Phospholine iodide is used in the ttt of glaucoma, prolonged used of
this agent reduces the activity of pseudocholinesterase,

Blood recalls

1. WBCs (leukocytes): basophils, eosinophils, monocytes, lymphocytes BUT NOT


reticulocytes (unmature RBCs)
2. The highest count in plasma cells is erythrocytes
3. The erythrocyte of an iron deficient pt is: microcytic, hypochromic - in iron deficiency,
the iron storage compartment becomes depleted, this is followed by reduction in the
plasma transferrin saturation, reduction in no and size and Hb content of RBC
4. Speed of blood is more in arteries than in arterioles
5. Schilling's test: pernicious anemia
6. Schilling test is useful for the detection of pernicious anemia. This test utilizes orally
administered vitamin B12 labeled with 57Co and 58Co. In normal individuals more than
50% of an oral dose of vit B12 is absorbed from GIT
7. RBCs + hypertonic solution = crenation
8. Proteins are present in blood more than urine
9. Polycythemia: mild polycythemia is normal in persons who exercise excessively and in
persons who live in high altitudespolycythemia vera:: is a disease state in which the rate
of red cell production is far greater than normal, even though there is no physiological
need for the increased production, it results from some sort of tumor in the bone
marrow
10. Plasma vol = 55ml/ kg body weight
11. "Plasma represent 55% of blood; i.e. 3500 mL of total blood volume, and 5% of total
body weight"
12. PH of blood=7.4
13. pH of blood = 7.4
14. Oprelvekin: inhance platelet production
15. Normal hematocrit value: 35-45%
16. No of RBCs in blood of healthy person=5*10 ⁶/ml
17. Na on blood= 137-157 mmol/L --- K in blood: 4.5-5.5 mmol/L ---Cl=98-100mmol/L ---
HCO3=24mmol/L --- urea=3-8mmol/L --- Ca=9-11mg% if more than 7: tetany
18. Na in blood= 137-157 mmol/L --- K in blood= 4.5-5.5 mmol/L -- Cl=98-100mmol/L --
HCO3=24mmol/L -- urea= 3-8 mmol/L -- Ca=9-11mg%
19. Microcystic anemia: MCV is less than 80 but normal range is 90
20. Metabolic acidosis is due to HCO3 loss
21. Megaloplastic anemia is due to foilc acid deficiency
22. Megaloblastic anemia ttt: leucovorin IM
23. Male hemoglobin: 14-17 g/dl --- female hemoglobin: 12-15 g/dl
24. Maintaining of blood PH is function of lungs and kidney
25. Hypoproteinemia cause edema
26. High protein bound drugs: warfarin, clofibrate, salicylates, barbiturates, sulfonamides,
tolbutamides
27. Hemoglobin quantity in 100ml of blood is 15g
28. Hemoglobin quantity in 100 ml blood is 15g
29. Hb in blood is 15g
30. Folic acid can interfer with the diagnosis of pernicious anemia
31. Filgrastim is a protein
32. Erythropoiesis is the stimulation of RBC formation from bone marrow
33. Erythrocytes are the highest count in plasma cells
34. Direct van den bergh test measures conjugated bilirubin in the blood
35. Deficiency in intrinsic factor:: pernicious anemia
36. Decrease protein in plasma causes edema
37. Dec plasma protein level leads to edema
38. Blood volume=5-6 L
39. Blood makes up 1/15 of body weight
40. Blood makes 1/15 of body weight
41. Bilirubin is the end product of hemoglubin decomposition
42. Bilirubin is the end product of hemoglobin metabolism
43. Average % of hematocrit in blood is 45%
44. Anemia is caused by: antineoplastics, cytotoxins, immunosuppressants
45. Agranulocytosis is caused by: chloramphenicol, carbamazepine, carbimazole, novalgin
(metimazole) sulphonamides, clozapine, ACEIs
46. Agranulocytosis is accompanied by necrotic lesion of mouth, also leukopenia,
neutropenia, also sore throat and fever
47. Agranulacytosis is decrease in polymorphonuclear lymphocytes
48. (continue polycythemia vera) phlebotomy whenever the hematocrit rise above 55% may
suffice as the only ttt for pts who do not have sever thrombocytosis -- phlebotomy:
opening a vein to let or draw blood, also called venesection
49. (continue polycythemia vera) drugs used include: busulfan (myleran),, radio active
phosphorus 32P
50. (cont. Schilling test), it has been shown that over 1/2 of an oral dose soon appears in the
blood, normally, only a small amount of radioactivity appears in the urine, however if a
large flushing dose (1000mcg) of vit B12 is given paentrally within
51. (cont. Schilling test) which results in poor absorption of the radioactive B12, most of
theradioactivity in those pts will be detected in the feces
52. (cont. Schilling test) this absorption occurs in the presence of the intrinsic factor of
Castle, with which the vit must presumably combine in order to pass through the
intestinal walls. By means or radioactive cobalt-labeled cyanocobolamine,
53. (cont. Schilling test) an hour of the tagged oral dose the renal threshold for B12 is
exceeded and radioactivity is observed in the urine. In pts of pernicious anemia, there is
a deficiency in interinsic factor,
54. Erythrocyte is non nucleated cell
55. Drug binding to plasma proteins study it well(many Q's)
56. Why is 5% Dextrose solution added to blood products? a) binding free iron b) good for
storage of the blood to prevent hemodialysis
57. Which cells are the majority in the blood?a) Erythrocytes b) Polygranulated blood cells
c) Platelets d) Lymphocytes
58. Protein concentration is more in blood than in urine
59. Why is 5% Dextrose solution added to blood products? a) binding free iron b) good for
storage of the blood to prevent hemodialysis
60. Which one is inert plasma expander... Ans. Dextran
61. Which cells are the majority in the blood? a) Erythrocytes b) Polygranulated blood cells
c) Platelets d) Lymphocytes
62. Drop in plasma protein level causes edema

Bone disease recalls

1. Which drug is given in alternate day and causes osteoporosis ?: predisolone


2. The cause of osteogenesis is genetic defect
3. "Sclerosis is generally caused by overgrowth of fibrous tissue -- spondylitis:
inflammation
4. of the vertebrea -- stasis: stoppage of blood flow in a part of the body"
5. Rheumatoid arthritis: inflammation of synovial fluid, membrane
6. Rheumatoid arthritis management: NSAIDs to maintain mobility, DMARD used after
NSAIDs -- DMARD: disease modifying antirheumatic drug
7. Penicillamine is a chelating agent used in rheumatoid arthritis
8. Penicillamine is a chelating agent and used in rheumatoid arthritis and wilson's disease
9. Penicillamine is a chelating agent
10. Paricalcitol: vitamin D analogue: ttt of hypoparathyrodism
11. Parathyroid gland affect Ca absorption
12. Osteoarthritis is a degenerative disease
13. Osteoarthritis is a degenerative disease
14. Manifestation of hypoparathyrodism: hypocalcemia, hyperphosphatemia
15. Leflunomide (immunomodulator, antiinflammatory used in the ttt of rheumatoid
arthritis) : pregnancy category X
16. In rheumatoid arthritis break down of synovial membrane occurs
17. Hypoparathyrodism ttt : calcitriol, vitaminD --- hyperparathyrodism ttt: calcitonin,
vitaminD analogue
18. Hypoparathyrodism is ttt by dihydrotachysterol
19. Etarnecept: parentrally used for rhematoid arthritis NOT for osteoarthritis
20. Early morning symptoms of stiffness, regidity: benztropin mesylate
21. Dose of colchicine is 500mcg orally
22. Dose of aspirin in rheumatoid arthiritis is 6 gm
23. Causes of osteoporosis: hyper cortisone secretion, hypoparathyrodism, drop in estrogen
level
24. Cause osteogenesis is chromosomal --- cause of osteoporosis is estrogen deficiency
25. Alendronate is not given to pt sitting or lying down because it cause esophageal ulcer
26. Rheumatoid arthritis leads to cartilage destruction
27. NSAIDs improve mobility in rheumatoid arthritis
28. Increased PO4 leads to hypocalcemia
29. Rheumatoid arthritis : pannus
30. PTH - calcium – vitamin d question
31. Patient with hypophosphatemia which ion inc. (ca+2 , k+,Na+)
32. Hypophosphataemia increases Ca ion
33. Rheumatoid arthritis : pannus
34. Agent that could be use in osteoporosis=biphosphonates, Ca, estrogen, calcitonin,
vitamin D, Na flouride, progesterone, androgens, calcitriols.
Calculations recalls
• Zero order reaction: rate process independent on drug conc or initial dose
• Vd of drug inc if amount of drug bound to plasma proteins dec
• Vd = dose / Czero
• To prepare buffer system of pH4 we use lactic acid of pKa 3.86
• To prepare a buffer system of PH 4 use lactic acid, pka=3.86 - in a system having
different pka, the most appropriate will be as equal as its PH
• TI= LD50/ED50
• TI= LD50/ED50
• Therapeutic index: LD50/ED50
• t90%= shelf life
• t1/2=0.7Vd/Cl
• t1/2 in 1st order kinetics is not affected by drug concentration
• Steady state is when amount administered = amount excreted
• Steady state depend on the half life of the drug??
• Solubility depend on isoelectric point
• Rate of drug elimination excreted by 1st order kinetics is greatest when blood
concentration is at its max
• Plasma concentration is affected by dose, clearance of drug
• Plasma concentration = dose / Vd
• pka= -log of ionization constant which indiactes relative strength of acid or base
• Ph of 0.001 NaOH is 11 . Ph + POH = 14 . PH + ( - log 0.001 ) = 14 . PH + 3 = 14 . PH= 11
• PH is equal to pka at half neutralization point
• Non-linear pharmacokinetics:: t1/2 inc as dose inc???
• NaCl equivalent is amount of NaCl teoretically render the same osmotic
pressurevequivalent to 1 gm of the substance and this value is used to estimate the
amount of NaCl needed to render a solution isotonic
• Loading dose depend on Vd and plasma concn
• LD50 is not variable between species
• Laws for calculation of child doses:: Young's rule (year+12) , Clark's rule, Frid's rule
• Knowledge of Vd allowes us to: determine amount of drug in body based on plasma
concn.
• Isotonicity is critical in S.C
• Initial plasma concn after IV administration depends on dose and clearance
• Initial plasma concentration after IV dose is affected by dose or clearance
• Inc partition coefficient: improve passive absorption of a drug
• In loading dose: Vd and desired amount of drug is important
• In a lipid soluble drug: dissolution is the rate limiting step
• If a fixed dose of drug is eliminated by first order kinetics at fixed dose interval, time to
reach platau level will depend on t1/2
• If a drug has a small Vd then it does not accumulate in various tissues and organs
• How can you detect that a certain drug accumulates in tisse: when Vd is > 1L/Kg
• Hight concentration of drug in plasma = higher bioavailability
• Half normal saline is hypotonic
• Half normal saline is hypotonic
• Given the half life of a drug is 1 year, after 3 years 12.5% are left
• Freezing point depression: coligative property
• Fick's law (diffusion) = dc/dt= D*S.A*(C1-C2)/L --- noyes witney:= dc/dt=dc*SA*(Cs-C)/H
• Drugs with low Vd has less accummulation in tissues
• Drug with pKa 6.2 will be 50% ionized in small intestine (pH 6.2)
• Drug accumulation in tissue is related to Vd
• Doubling the drug concn in the blood (that follow 1st order kinetics) = will not affect the
half life
• dose = Vd * Czero
• Dissolution rate is the rate limiting step affecting absorption of oral drugs
• Decay of radioactive atom occurs at 1st order reaction
• Conc of 6ppm= 0.00006%
• Class A prescription balance sensitivity tests: arm ratio, rider, graduated beam, shift,
minmum wt=120mg
• Class A prescription balance sensitivity tests: Arm ratio, Rider, graduated beam, shift ---
minimum wt: 120 mg
• Calculation of dextrose isotonic solution can be done by freezing point method
• C zero = dose / Vd
• Bioavailability is the mount or drug available in blood and the rate by which it was made
available
• An isotonic solution is isoosmotic but not vice versa
• A specific drug with 1st order biological t1/2 of 4 hrs, this value is independent on the
initial drug conc.
• A drug which is 20% absorbed from the oral dose is considered poorly absorbed in terms
of bioavailability
• Volume of distribution definition
• Definition of osmotic pressure
• Boric acid has pka 9.24 is very weak acid
• 7 problems 3 : kinetics and 4 pharmaceutical calculations
• You will be given t ½ 1 hour and will be asked how much time will it take for the 95%
drug to clear from the body?t1/2 = 50% drug in the blood = 50% drug out of the
body..t1/2= 25% of drug in the blood= 75% drug out of the body....t1/2= 12.5% of drug
in the blood=87.5% drug out of body...t1/2=6.25% of drug in the blood=93.75% drug out
of body...t1/2=3.125% of drug in the blood=96.875% of drug out of body
• Questions on Css calculations concentration of steady state? And maintainance dose
and loading dose.
• If the parient is given parentral nutrition then whoe many kilojoule energy will be
produced?The injection content will be given. In that fats will be there proteins/ amino
acids will be there and you will be asked the fats will produce how much energy?
• Calculations on volume of distribution Vd and from t1/2 and F bioavailability?
• Calculations on Fe++ mEq from (FeSO4. 2H2O) injections.
• Sucralfate compounding calculation from sample question 2014 (6.67 %)
• Conc is 200 mg at t half is 4 hrs .what conc after 16 hrs?
• Bioavaiabiliy determinent in regular immidiate release tablet? Dissolution -
dissintegration- metabolism-.....
• Which iron salt has the most „iron in weight to weight“?a)Ferrous fumarate..b) Ferrous
succinate...c) Ferrous sulphate, dried..d) Ferrous glycinate
• Vd definition
• Patient take Iv infusion dose Css affected with (half life – dose and clearance
• Elimination constant is 0,173 per hour, how much steady state is left after 16h?a)
25%..b) 50%..c) 75%..d) 87,5%..e) 93.75%
• Calculation Make a Solution with 274g Citric acid anhydrous, M= 192g/mol. How much
Citric acid Monohydrate do you have to use? (30 gm).
• Calculate the infusion dose for a patient 35years old, 70kg, V=9L, Serum
concentration=15mg/dL, t=10h, t1/2=1h.Result given in mg/h
• Calculate hepatic clearance when renal clearance is86mL/min. Same patient as in 40.
Except serumconcentration is 150mg/l.
• The Sensitivity of a balance is 5mg. What is the lowest weight you can measure with this
balance if the maximum error is +/- 5%? a) 100mg b) 50mgc)1000mg
• Potassium permanganate 2% dispensed 300ml, doctor want to give dose as 1:1000
using measure of 50ml.-dilute 5o ml to 1L water
• Half life definition
• Drug has a pKa of 4.5:a) if the pH is lower than 4.5, the partition coefficient will increase
b)if the pH is higher than 4.5, the partition coefficient will increase c)if PH is higher than
4.5 ionization will increase d)if PH is higher than 4.5 solubility will increase
• Calculation Patient has to take 300mg/10mL ferrous something*2H2O three times daily.
How much Iron is in a daily dose? M(Water)=18g/mol, M(iron)=55g/mol, Ferrous
something 2 H2O =156g/mol
• Steady state after continuous IV infusion depends on half-life
• Sensitivity calculation
• ppm to %conversion 600ppm to %
• mmol Kcl calculation
• Half life 4.9 days, steady state is 15 to 20 days
• Fe2SO4.7H20 atomic weights were given; find out elemental iron present in 300 mg
tablet?
• Creatinine clearance involving AUC and t1/2
• Concentration conversion
• Calculation question on chlorhexidine gluconate, Molecualar weights were given, find
amount of chlorhexidine present in 200g?
• After oral administration, plateau represents Half life
• Which iron salt has the most „iron in weight to weight“? a)Ferrous fumarate b) Ferrous
succinate c) Ferrous sulphate, dried d) Ferrous glycinate
• What to use for making buffer PH 4… lactic acid with PH 3.86
• What is Absolute Bioavailability
• The Sensitivity of a balance is 5mg. What is the lowest weight you can measure with this
balance if the maximum error is +/- 5%? a) 100mg b) 50mg c)1000mg
• Some graph is given........calculate clearance...
• Some calculation of stock solution
• Patient take Iv infusion dose Css affected with (half life – dose and clearance)
• Half life definition
• Elimination constant is 0,173 per hour, how much steady state is left after 16h? a) 25%
b) 50% c) 75% d) 87,5%e) 93.75%
• Drug has a pKa of 4.5: a) if the pH is lower than 4.5, the partition coefficient will increase
b)if the pH is higher than 4.5, the partition coefficient will increase c)if PH is higher than
4.5 ionization will increase d)if PH is higher than 4.5 solubility will increase
• Conc is 200 mg at t half is 4 hrs .what conc after 16 hrs?
• Calculation. Mostly dilution and allegation method and involved ppm, % to ratio, g to
mg etc (basic things)
• Calculation Patient has to take 300mg/10mL ferrous something*2H2O three times daily.
How much Iron is in a daily dose? M(Water)=18g/mol, M(iron)=55g/mol, Ferrous
something 2 H2O =156g/mol.
• Calculation Make a Solution with 274g Citric acid anhydrous, M= 192g/mol. How much
Citric acid Monohydrate do you have to use? (30 gm).
• Calculate hepatic clearance when renal clearance is86mL/min. Same patient as in 40.
Except serumconcentration is150mg/l.
• 40. Calculate the infusion dose for a patient 35years old, 70kg, V=9L, Serum
concentration=15mg/dL, t=10h, t1/2=1h. Result given in mg/h

Cancer recalls

1. When dispensing the fluorouracil solution patient should be advised to: apply with a
nonmetalic applicator or fingertips, avoid prolonged exposure to sunlight, avoid
exposure to UV, erythema will occur after application, do not cover with occlusive dressi

2. Vincristin: only IV, little BMD


3. Tamoxifen citrate is indicated primarily for estrogen-dependent neoplasm
4. Storage of cisplatin: store from 15-25 C, do not refrigirate, protect from light, discard
unused portion
5. Storage of cisplatin: at room temperature or from 15-25 C - SE: proximal renal tubular
damage (nephrotoxicity) -- amifostine: ttt of cisplatin toxicity, protect from
nephrotoxicity by cisplatin
6. Some antineoplastic agents:: alkylating agents: nitrogen mustard, chlorambucil,
cyclophosphamide -- antimetabolites: MTX, 6-MP, 5-FU
7. Prednisone, 6-MP, chlorambucil Rho (D) immunoglobulin:: useful immunosuppressants
in cancer chemotherapy
8. Nadir: time before BMD max occurs
9. MTX is clinically used for psoriasis and RA and leukemia
10. MTX is antagonist to folic acid
11. Methotrexate + salicylate = bone marrow depression
12. Mesna: Na-mercapto ethane sulfonate
13. Mechloethamine (alkylating agent) : potent vesicant --- extravasation ttt: thiosulfate, ice
compresses
14. Folinic acid is antidote for MTX --- MTX is folic acid analogue used in leukemia
15. Folinic acid is antidote for methotrexate --- methotrexate is folic acid analogue used in
leukemia
16. Fluorouracil is an antimetabolite antcancer drug
17. Filgrastim is granulocyte-colony stimulating factor which stimulates the production of
neutrophils
18. Filgrastim ( granulocyto colonies stimulator) : ttt of BMD with sever neutropenia
19. etoposide: antineoplastic, have been approved for use in combination of (ex: cisplatin,
vinblastin, bleomycin) in pts with refractory testicular tumors who have already received
appropriate surgical, chemotherapeutic and radiation therapy
20. Doxorubicin causes cardiac cumulative toxicity
21. Doxorubicin cause cardiac toxicity
22. Docetaxel: ttt of breast/non-small lung cancer --- monitor: bilirubin, SGOT, CBC -- SE:
edema
23. Dactinomycin, mithromycin are antibiotics and anticancer due to their cytotoxic effects
24. Cyclophosphamide: alkylating agent BUT cytarabine is NOT
25. Cyclophosphamide, methotrexate cause total BMD
26. Cyclophosphamide, methotrexate = total BMD
27. Cyclophosphamide SE: hemorrhagic cystitis
28. Cyclophosphamide SE is hemorrhagic cystitis which is ttt with mesna
29. Cyclophosphamide cause hemorrhagic cystis
30. Cisplatin SE: proximal renal tubular damage
31. BMD leads to agranulocytosis
32. Amifostine: ttt of cisplatin toxicity, protect from nephrotoxicity by cisplatin
33. 6-thioguanine cytotoxicity effect by guanine synth
34. 5-FU causes marker BMD
35. (continue etoposide) the marketed soln is diluted with D5W or 0.9% saline injection and
given IV for a 30-60 min period.. Severe BMD is the most serious adverse effect, there is
a high incidence (30%) of nausea and vomiting
36. (continue etoposide) it holds promise in ttt of small cell ling cancer and other
carcinomas - it's a semisynthetic deriv of podophyllotoxin, an active constituent of
podophyllin. It acts as an inhibitor of cell mitosis
37. Metastatic bone pain is treated by fentanyl patches
38. Determination of chemotherapy dose includes all the following except age factor
39. Detection of breast cancer attained by mammography
40. Another case about anticancer drug-i don't remember it- (tough one) about also 5Q's
41. All are alkylating agents except cytarabine
42. Doxorubicin: causes cardiac toxicity
43. Side effect of Daunorubicin........Cardiotoxicity
44. Patient on methotrexate perfusion, to prevent toxicity from happing he should take folic
acid with methotrexate
45. Methotrexate toxicity treat with leucovorin
46. Doxorubicin: causes cardiac toxicity
Ceutical recalls

1. Penicillin in a B-lactam ring erythromycin has a lactam ring


2. Tetracyclines give different absorption and dissolution patterns cause it is amphoteric
(form salts with acids and bases, capable of forming internal salts
3. When hexyl resorscinol is exposed to air it will be oxidized
4. Volatiles oils are rich in terpentines
5. Volatile oils are terpines
6. Volatile oil is rich in terpentine
7. Types of bonds usually seen in complexes are hydrogen bonds
8. The UV range used in spectrophotometry is 200-400 nm
9. The structure of sulfonylureas can be substituted at R1 and R2 positions -- 2nd
generation have larger substitutions on R1
10. Sulphonamides must have a nonsubstituted aromatic amine essential for antibacterial
activity (metabolized by acetylation)
11. Substitution of cephalosporines at C7 inc B-lactamase stability
12. Substitution od cephalosporines at C7: increase stability to B lactamase
13. Structure of estrogen is a steroid
14. Stearic acid + KOH = soap
15. Soap is formed by reaction of inorganic base with organic acid
16. Salicylic acid + cholroform + H2NO3 = pptn of salicylic acid in the lower layer
17. Racemic mexture is optically inactive because it contains equal amounts of D and
Lstereoisomers
18. Phenyl group in phenyl Hg nitrate leads to less solubility than organic salts
19. Phenyl group in phenyl Hg nitrate leads to less solibility than other inorganic salts
20. Phenol, NH4Cl,= acidic -- NaHCO3, amphetamine, acetazolamide = basic
21. Phenol is acidic
22. Phenol + (hydration)= 1,2-benzodiol
23. Paraldhyde is acetaldhyde polymer
24. Paraldhyde is a polymer of acetaldhyde -- paraldhyde is oxidized to acetic acid
25. Para amino benzoic acid=PABA--- ethyl amino benzoic acid=benzocaine
26. Ortho position= 1 and 2 position on benzene
27. Optically active means that the compound has assymetric C
28. Optical enantiomers: due to one assymmetric carbon atom, consider mirror image e.g:
epinephrine --- diastereomers: due to 2 or more assymetric C atom and not mirror
image e.g: ephedrine
29. Optical activity is due to assymetric C atom
30. Oleic acid exists in cis form : 2 groups fixed around a double bond on the same side
31. Number of sterioisomers of a compound with 4 assymetric carbon atoms =16
32. NHNH- is present in MOAI structure (phenelzine)??
33. NH-NH- is present in MAOI structure phenelzine
34. Methylparaben is ester of parahydroxybenzoic acid
35. Methylcellulose + p-hydroxybenzoic acid is estrification reaction
36. Lactulose is synthetic disaccharide
37. Lactic acid= 2-hydroxypropanoic acid
38. Lactic acid CH3-CHOH-COOH (optically active) + [oxidation]=pyruvic acid CH3-COCOOH
(optically inactive) +[ reduction]=lactic acid (reversible reaction)
39. KOH + organic acid = soap
40. KOH + organic acid = soap
41. Introduction of halogen to acids inc acidity
42. If salicylic acid is added to chloroform then H2SO4 was added : salicylic acid will ppt inc
the lower layer
43. Glycerine syrup is neutral
44. Glucose shows no absorbance in the UV region of 200-400 nm
45. Glucose cannot be detected or measured by the UV light because it shows no
absorbance in this range: 200-400 nm wavelength
46. Estrification: OH group from acid is replaced by RO from alcohol
47. Estimation of glucose amount in solution can be done by: action of glucose peroxidase,
colorimetric method, titration BUT NOT by UV method
48. Erythromycin structure is a macrocyclic lactone ring attached to a sugar moiety
49. Ephedrine, levofloxacin, carvedilol are optically active
50. Ephedrine is optically active , diastereoisomer
51. End product of glycogen is glucose
52. Dioctyl Na sulfosuccinate = docusate Na (anionic)
53. Conformation isomerism: it's orientation of molecules which result from rotation of
atoms about bonds, called rotamers
54. Conformation is rotation about a single bond
55. Compounds containing aldehyde and keto groups , barbiturates , caffeine
56. Cis means 2 groups on the same side
57. Chiral C atom= asymmetric C atom
58. CH3COOH + ROH=CH3COOR +H2O (OH from acid, H from alcohol)
59. CH3-(CH2)16-COOH is stearic acid
60. Celecoxib contains sulfa group, salfasalazine contains sulfa group, BUT trimethoprim
does NOT contain a sulfa group
61. Camphor is ketone
62. Camphor is ketone
63. Bonds in protein are polypeptide bonds
64. Benzocaine is ethylaminobenzoic acid
65. Benzene ring structure: easily determined by UV
66. BaSO4 is the least soluble compound
67. Atropine structure is similar to acetylcholine
68. Atropine is sol in acid forming atropine sulfate
69. Amphoteric drugs don't change PH: e.g. tetracyclin
70. Amoxicillin is more absorbed than ampicillin because it has a para hydroxyl group
71. Activity of phenol inc with increasing temperature
72. Acetaldhyde polymerization = paraldhyde
73. 32P is radioactive
74. 2ry alcohol is oxidized to ketone - 1ry alcohol is oxidized to aldehyde
75. 1ry alcohol oxidation gives aldehyde --- 2ry alcohol oxidation gives ketone
76. 1,2 bezodiol formed by hydration of phenol
77. Zwitter ion structure
78. Structure of cisplatin
79. Phenthiazine general structure
80. Phenobarbitone contains keton group
81. Oxidation of 2ry alcohol gives ketone
82. Organic structure conformation detected by NMR
83. Ketoprofen is propionic acid derivative
84. Formation of ester occurs by acid alcohol reaction
85. Equatorial arrangement
86. c-o-c is ether
87. Chlorpheniramine is alkylamine derivative
88. Ampicillin side chain
89. Addition of (CH3)4 to NH4 leads to N+
90. Which of the following functional group is responsible for Atropine instability?a.
ether…..b. ester...c. amino..d. heterocyclic ring
91. UV rays are useful for detection of which of the following molecule? Sorry no idea of
options may be it was benzene ring or something
92. Following structure is present in which one of the folloing molecule?a. Vitamine C...b.
Vitamine B...c. Vitamine D..d. Vitamine A
93. Basic stereo chemistry For example what will be the mixture in final solution if the
molecule has more than 1 chiral centers? Enantiomers or diastereomers etc.
94. Barbiturate over all is a(an):a. acidic..b: basic...c:neutral...d. non electrolyte
95. Why amoxicillin is better than ampicillin in absorption? I think due to P-OH group
96. What Dextro- means? Ans;: rotate polarize light to right
97. Question related to sulfoxazole sodium structure?why we use sodium salt?
98. CH3-CH2- group name ? Ethyl- methyl- acetyl -....
99. Which of this medication dose not have active metabolite- temazepam- fluoxetine -
famciclovir-amiodarone
100. Structure of sodium acetate hydrocortisone ..a) Sodium at the acetate part to
increase solubility...b) a part of the acetate will bind with another part of the
hydrocortisone and form a ring...c) Ester part will hydrolyze in the blood and free the
Hydrocortisone (I think it is the correct answer)
101. "Structure of promethazine and ask which make this antihistamine different
than other antihistamine: a) the Nitrogen atome binds to two rings which form another
ring with each other..b) The Nitrogen in the Amino group comes after 2 carbon atoms..c)
big three ring structure
102. "
103. Phenobarbital sodium in aqueous solution: acidic-basic-neutral
104. Cimetidine structure given and asking which compound derived from:
histamine
105. Alcohol structure
106. Which one cannot be detected by uv: para hydroxyl benzoic - tartaric –
phenothiazines
107. What is this structure : (given amino acid structure) a) Ketone b) Amino Acid
108. UV range: 200 – 400
109. The structure to be chiral-rotate 90degree on the plain polarized light..- the
conformers could be known by physical properties ..- has a plain of symmetry ...- D
mean plain polarized to rotate to the right
110. Sulphone formation in vivo due to:-oxidation of marcaptans-oxidation of
mercapturic acid
111. Structure of thiazide
112. Structure for epinephrine :- catecholamine- dopamine- thiazide
113. Penicillin v structure
114. (+ -)racemic means:-different chemical properties- has same physical activity-
optical active center
115. UV range: 200 - 400 nm
116. Trans ethylstilbestrol, groups on both sides
117. Tetracycline: both acidic and basic
118. Sulphonyl urea structure
119. Sulfonamide structure is given: antibacterial activity
120. Stereochemistry points, select wrong answer: D rotates plane polarized light to
right, which is wrong because it represents D-glyceraldehyde
121. Select wrong answer about isomerism, Enantiomers are same as diastereomers
122. Pyrrole structure
123. Phenobarbital acid or basic
124. P-amino benzoic - sodium carbonate- valproic acid- benzoic acid.. is detected by
UV
125. Nicotine water solubility due to N
126. Indomethacin SAR and metabolism
127. Hg binding to Dimercaprol in which way? Antidote of mercury identify
structures
128. COOH group: carboxyl
129. Conformers can be differentiated by .. Melting point… boiling point
130. Ampicillin side chain and sulfonamide identification
131. Why amoxicillin is better than ampicillin in absorption? I think due to p- oh
group
132. Which one is not an isomeric mixture?
133. Which one cannot be detected by uv: para hydroxyl benzoic - tartaric –
phenothiazines (I think tartaric)
134. Which of this medication dose not have active metabolite - temazepam -
fluoxetine -famciclovir -amiodarone
135. What is this structure : (given amino acid structure) a) Ketone b) Amino Acid
136. What Dextro- means? Ans;: rotate polarize light to right
137. Uv range: 200 – 400
138. The structure to be chiral -rotate 90degree on the plain polarized light - the
conformers could be known by physical properties - has a plain of symmetry - D mean
plain polarized to rotate to the right
139. Tetracycline has an amphoteric structure
140. Sulphone formation in vivo due to: -oxidation of marcaptans-oxidation of
mercapturic acid
141. Structure of thiazide
142. Structure of sodium acetate hydrocortisone Choose the right answer a) Sodium
at the acetate part to increase solubility b) a part of the acetate will bind with another
part of the hydrocortisone and form a ring c) Ester part will hydrolyze in the blood and
free the Hydrocortisone (I think it is the correct answer)
143. "Structure of promethazine and ask which make this antihistamine different
than other antihistamine: a) the Nitrogen atome binds to two rings which form another
ring with each other b) The Nitrogen in the Amino group comes after 2 carbon atoms
144. c) big three ring structure"
145. Structure of ascorbic acid and asked what is it… lactone
146. Structure for epinephrine : - catecholamine - dopamine - thiazide
147. SAR of sulindac… COOH is necessary, prodrug formation was counter productive
etc
148. Radiating Substance......what is the half life. .....Ans. It follows 1st order kinetics.
So calculate according to that
149. Racemic means: -different chemical properties - has same physical activity -
optical active center
150. Question related to sulfoxazole sodium structure?why we use sodium salt?
151. Polymorphism.....Which is not a property of it?...... Ans. X-ray.
152. Phenobarbital sodium in aqueous solution: acidic-basic-neutral
153. General structure of: steroid, antihistamine
154. Cis trans isomerms are diasteriomers
155. Cimetidine structure given and asking which compound derived from:
histamine
156. CH3-CH2- group name ? Ethyl- methyl- acetyl -....
157. Alcohol structure
158. Sodium metabisulfite: acidic--glycerol, ethanol, KI, NaCl,:neutral---Na borate:
alkaline
159. Organic acid + inorganic base= soap
160. NaHCO3 is a weak base
161. Na stearate may render benzalkonium soln inactive
162. Lactic acid oxidation gives pyruvic acid
163. Glycerine is alcohol -- gelatin is a protein
164. Ethylene glycol oxidation gives oxalic acid
165. Erythromycin structure is lactone ring with sugar moiety
166. Which of the following is ion present in vitamine B12?a. Ferrous...b. cobalt...c.
magnesium..d. calcium
167. Clindacyn dissolve in H2O NOT alcohol
168. Bear's lambert's law relate the absorption of light to wave length

Ceutics recall

1. Wool fat (anhydrous lanolin) -- lanolin contains more water than wool fat (anhydrous
lanolin)
2. With hydrocortisone use simple base or soft parrafin
3. When a soln, is separated from its solvent by a semipermeable membrane, solvent will
pass through the membrane
4. Types of bonds usually seen in complexes are hydrogen bonds
5. Tweens give o/w emulsions
6. Tweens = polysorbate
7. Trituration: grinding
8. Trituration is grinding to fine powder
9. Tragacanth is used to increase viscosity
10. Titanium dioxide: sunscreen agent
11. Titanium dioxide is sun blocking agent
12. Thermolabile sterilization technique using aseptic technique by 0.22 microne filter
13. The emulsifying agent with chlorhexidine is cetrimide
14. The emulsifying agent of Ca(OH)2 and olive oil (oleic acid) is Ca oleate
15. The emulsifying agent in olive-lime water emulsion is : Ca oleate
16. The drug to be available in the plasma should be in soln form
17. The base used with hydrocortisone is simple ointment or soft parafin
18. Syneresis:: gels contract, lose fluid
19. Suspensions are not suitable for IV injection
20. Stool softeners frequently anionic surfactant which is dioctyl Na sulfosuccinate
=docusate Na
21. Stock's law for sedimentation rate ---- fick's law for diffusion rate
22. Sterilization of water for injection: by distillation, reverse osmosis
23. Sterilization of soft lenses: boil in water for 15-30 minutes, use chlorohexidine 0.01% for
soft lenses, use benzalkonium Cl 0.02% for hard lenses
24. Sterilization of parentrals , oils by dry heat at 170 C for 2 hrs
25. Sterilization of oils, fats, powders: dry heat at 160 C for 2 hrs
26. Sterilization of contact lens by soaking in saline or preservative
27. Sterile H2O for injection is prepared by distillation then autoclaving ???
28. Stearyl alcohol, cetyl alcohol are used as stabilizers
29. Stearyl alc, cetyl alc, cholesterol are used as stabilizers
30. Stearyl alc, cetyl alc, cholesterol are stabilizers
31. Steady plasma level depend on infusion rate
32. Stabilizers: cetyl alcohol, stearyl alcohol, cholesterol
33. Stability of emulsion depend on method of agitation
34. SR tablets are swallowed as a whole
35. Spans give w\o emulsions
36. Sorbitane monostearate gives W/O emulsion
37. Sorbitane monostearate (nonionic) w/o emulsion--- Na lauryl sulfate = O/W --- dioctyl
Nasulphosuccinate = O/W
38. Sorbitan monostearate gives W/O emulsion - sorbitan sesqioleate ( in
hydrophilicpetrolatum base )
39. Sorbitan monostearate (non ionic surfactant)== gives W/O emulsion
40. Solvent used with hydrocortisone IV injection is propylene glycol ???
41. Solvent used with HCTZ injection is propylene glycol
42. Solubilized vit A is a micellized dispersion of vit A an SAA
43. Soda lime sol + air CO2 = CaCO3 ppt
44. Silica: # moisture deterioration of drugs
45. Semithicone is antacid antifoaming agent
46. SAA is added to tablets to act as a binder and adhesive and improve dissolution and
bioavailability
47. RX containing: kaolin + aluminium + chalk= astringent
48. Rose oil + cetrimide is stabilized by aggitation
49. Rose oil + cetrimide 20 % is stabilized by agitation
50. Rideal walker test = germicidal efficacy of antiseptics
51. Refractometer depend on density
52. Refractiometer depend on difference in density between 2 substances
53. Reduction of particle size do not show difference of disintegration
54. Reduction in particle size do NOT show difference in Xray
55. Rectal supposotories adults=2g pediatric=1g
56. Rate of emulsion creaming depend on viscosity
57. Rate of emulsion creaming depend on viscosity
58. Rancidity is the oxidation of double bonds in fatty acids
59. Radial Walker test is used to estimate disinfectant/germicidal activity
60. Pyrogens: bacterial byproducts cause febrile reaction
61. Pyrogen causes fibrile reaction
62. Purified water for injection is prepared by distillation
63. Prodrug is an inactive form of the drug
64. Preservatives: chlorobutanol, dehydroacetic acid, K-sorbate, cresol, thiomersal,
benzalkonium. Benzoic acid, benzyl alcohol, cetylpyridinium, phenol
65. Preservatives in eye drops : chlorocresol 0.1 % , benzalkonium chloride 0.02 %
,chlorohexidine 0.01 % , Na edetate 0.1 % , phenyl mercury nitrate 0.002 % , cetrimide
0.005% -% of chlorocresol is 0.05-0.1%
66. Polysorbates (tweens) is used as detergents ans solubilizing agents (o/w emulsifyling
agent) high HLB -- sorbitan (spans) are used as wetting agent (w/o emulsifying agents)
low HLB
67. Polysorbate is used as wetting agent
68. Polysorbate is used as detergent, solubilizing agent --- sorbitan is used as wetting agent
69. Polysorbate is known as wetting agent
70. Polysorbate 80 assist in dispersion of cooltar
71. Polyoxyalkylenes = spans , tweens
72. Polymorphs differ in: melting points, solubility, dissolution rate, density, stability, BUT
NOT PH
73. Polymorphs differ in: melting point, solubility, dissolution rate, desitym, stability BUT
NOT Ph
74. Polymorphs differ in solubility and melting point
75. Polymorphism affect the solubility of the drug
76. Polymorphic drugs are different in all except PH in soln
77. Plastic which is not affected with autoclaving is PVC
78. Phenol + mentol + camphor = eutectic mixture
79. Phenol + menthol + camphor = melt giving eutectic mixture
80. Pharmacist should suggest to pt that a supp. Made with carbowax and glycerinated
gelatin as base should be dipped in water before insertion
81. Petrolatum is soluble in vegetable oil , chloroform , ether . Petrolatum is insouble in
water, ethanol, acetone
82. Oral drug with weak PH is more absorbed from stomach
83. Oral drug absorption rate is affected by its dissolution not disintegration rate
84. Opthalmic solutions are sterilized by filteration by a 0.22 microbial filter or heat with
bactericidal
85. Olive oil + lime water = calcium oleate ( stabilizer )
86. Olive oil + lime water = Ca oleate (emulsifier)
87. Olive oil + lime water = Ca oleate
88. Olive oil + lime water= Ca oleate (emulsifier)
89. Oleic acid is monounsaturated fatty acid --- linoleic acid is polyunsaturated fatty acid
90. Ointment base is made of hydrocarbons
91. Oily antioxidants:: BHA:butylated hydroxy anisol , tocopherol, BTH: butylated hydroxy
tolwene, ascorpyl palmitate, propyl gallate
92. Oils, fats, powders are sterilized by heat at 160 DC for 2 hrs
93. Non ionic cetomacrogen 1000 is compatible with: salicylic acid, camphor, KI NOT with
phenol
94. Non ionic cetomacrogel is compatible with: salicylic acid, camphor, KI BUT NOT with:
phenol
95. Non inonic emulsion: cetomacrogel -- anionic: Na lauryl sulfate (soap) -- cationic:
cetrimide, benzalkonium chloride
96. Needle with smallest diameter carry the greatest number
97. NaCl (neutral) does not change PH of the medium
98. Na stearate (soap) = anionic SAA
99. Na phenbarbitone yields alkaline solution
100. Na metabisulfite is an antioxident or a reducing agent -- it changes the PH to
acidic -- glycerine (neutral) does not change the PH of the medium
101. Na metabisulfite is an antioxidant
102. Na metabisulfite is an antioxidant
103. Na lauryl sulfate is incompatible with cetrimide BUT compatible with icthamol
104. Na lauryl sulfate is an anionic surfactant so its incompatible to cationic SAA
105. Na bisulfite is antioxidant, change pH of medium
106. Na benzoate is used as a preservative
107. Most volatile oil is menthol
108. Most vaginal suppositories use a base of PEG
109. Mineral oils are not miscible with alcohol, chloroform, ether, benzene
110. Mineral oil: antioxidant is added to prevent peroxide formation, mixture of
hydrocarbons obtained from petrolatum, immiscible with castor oil, immiscible with
alcohol, specfic gravity is more than 1
111. Mineral oil is petrolatum derivative (aliphatic hydrocarbon) and immiscible in
alcohol or castor oil
112. Mineral oil is mon miscible in alcohol
113. Methyl paraben is used to prevent mould, yeast growth
114. Methyl paraben is ester of hydroxybenzoic acid
115. Methyl paraben is an ester of benzoic acid and parahydroxy benzoic acid --
prevent yeast and mould growth
116. Lyopophopic colloids:: inorganic particles: Au, Ag. Small electrolyte concn: pptn,,
inc concn of particles: constant viscosity
117. Low diameter of needle: high gauge number
118. Liquid in liquid dispersion system is emulsion
119. Light passes through a solution depending on solute concentration
120. KI is used as enteric coated tablets to decrease irritation
121. KCl therapy is given by slow IV infusion
122. Intra-articular: in the joint -- intrasynovial: in the joint fluid -- intrathecal: in the
spinal fluid
123. Intermittent IV therapy is used to: avoid anticipated stability or comptability
problems, dec the potential of thrombophlebitis, better diffusion of some drugs into
tissues
124. Insulin needle , boil with H2O for 30 minutes
125. Initial calibration mark on ml graduated pipette in 20 ml
126. Increase partition coefficient of drug = increase passive absorption
127. If oral coated tablet is used:: disintegration will be the rate limiting step
128. Hydrophilic depend on osmolarity -- hydrophobic depend on partition
coefficient
129. Horizontal laminar flow is better than vertical laminar flow --- tests for it: DOP,
smoke test, microbial test
130. HNO3 conc= 0.002% --- phenyl Hg acetate=0.002%
131. HNO3 conc : 0.002% -- phenyl Hg acetate 0.002%
132. HLB is important for classification of nonionic SAA
133. HgCl2: very water soluble --- BaSO4 is the least soluble
134. HgCl2 is very water soluble --- BaSO4 is the least soluble
135. Hexyl resorcinol is oxidized upon exposure to air
136. H2O at pH 9 is best solvent for barbiturates (alkaline water)
137. Greatest drug concn gradient between blood and tissue will occur when drug is
administered by IV bolus
138. Glycerine suppositories: 92% glycerine + Na stearate // 70% glycerine + 14%
gelatine + H2O
139. Generic= drug having same ingredient as the brand drug
140. Gelatin is a protein
141. For sustained release K= use inner wax matrix
142. Flexible collidion contains camphor+ castor iol
143. Ficks law of positive diffusion
144. Fick's law for passive diffusion
145. Fick's law (diffusion) = dc/dt=D*S.A*(C1-C2)/L --- noyes whitney's law=
dc/dt=dc*S.A*(Cs-C)/h
146. Eutectic mixture: mixture of chemicals in which they melt (liquify) at a
temperature lower than their melting points (menthol + camphor + phenol)
147. Ethylpalmitate is not SAA
148. Ethyl stearate or ethyl palmitate are NOT surface active agents
149. Ethyl palmitate/ ethyl stearate are not SAA
150. Ethyl palmitate is not SAA
151. Ethanol, KI, syrup are neutral do not change the PH of the medium but Na
metabisulfite is acidic and Na borate is alkaline, KBr alkaline
152. Emulsion is liquid in liquid dispersion system
153. Emulsifier used with salicylic acid prepartions is wool alcohol???
154. Emulsifier used with salicylic acid preparation is wool alcohol
155. Econazole nitrate: o/w emulsion, compatible with anionic SAA
156. Drugs that require pateint package insert: isotretenoin, OC, isoproterenol,
ticlopidine, progesterone, estrogen, IUD (intrauterine device)
157. Drugs thae can be destroyed by heat in the autoclave: procain, penicillin, insulin,
Ab?, phenylephrine, heparin
158. Drugs excreted by passive tubular reabsorption = aspirin, amphetamine
159. Drug tolerance = reduced pharmacologica response due to repeated
administration
160. Dressing is used with cortisone to increase absorption
161. "Dispersion types: 1-molecular (less than 1nm) pass ultrafilter, semipermeable
membrane,
162. ex: oxygen, glucose --- 2- colloidal dispersion: (0.5-1 micron) pass only filter
membrane, ex:
163. silver solution --- 3-coarse dispersion"
164. Diluted acetic acid is 6% w/v of pure acetic acid
165. Dilatant viscosity inc by agitation
166. Diethylether is used to prevent peroxide which is a toxic compound
167. Creaming in emulsion depends on difference between 2 phases
168. Cool tar may be mixed with salicylic acid
169. Contact angle is used to measure friction coefficient of powder
170. Conc of chlorohexidine is : 0.01%
171. Colloids:: 1-lyophyllic colloids, 2-association colloids, 3-lyophobic colloid ---
lyophilic colloid: organic disperse molecules, inc concn: inc viscosity, may transform
from solution to gel, addition og high electrolytes: pptn. (salting out)
172. Coal tar is mixed with polysorbate 80 to assist its dispersion
173. Clinical investigation of a new drug consists of 4 phases: first phase include
administration of drug by selected clinicians to healthy volunteers
174. Chlorohexidine is compatible with cetrimide o/w emulsion
175. Chlorohexidine is compatible with cetrimide
176. Cetyl pyridinium bromide (cetrimide)= cationic emulsifying agent
177. Cetrimide is used to for O/W emulsion of chlorohexidine
178. Cetrimide gives O/W emulsion
179. Cetrimide give O/W emulsion
180. Cetostearyl, and cholestrol : stabilizers
181. Cetomacrogel/ emulsion wax = W/O emulsion ---Na lauryl sulfate + cetostearyl
alc (anionic) = O/W -- cetrimide + cetostearyl (cationic) =O/W -- cetomacrogel 1000 +
cetostearyl (nonionic)= O/W
182. Cetomacrogel is incompatible with tannic acid, NH4 salts, phenol
183. Cetmacrogel= nonionic SAA that is incompatible with tannic acid, NH4 salts and
phenol
184. Cellulose acetate phthalate: used in enteric coated tablets
185. Camphor is not freely dissolved in water, it is insoluble in water, soluble in
alcohol
186. Calamine lotion consists of ZnO and ferric oxide
187. Calamine lotion = ZnO + ferric oxide
188. CaCl2 will not be active when given orally
189. Butylated hydroxy tolween (BHT): oily antioxidant -- like it: butylated hydroxy
anisol (BHA) , ascorbyl palmitate..
190. Buffer soln resists PH change
191. Body placed in hypertonic solution will dec in size
192. Benzalkonium chloride is a cationic germicidal SAA
193. Benzalkonium chloride (cationic germicidal surfactant) is inactivated by soap
(anionic SAA)
194. Bendict's soln depends on the reduction of cupric ion to cuoroic acid
195. Bear's Lambert's law relate the absorption of light by solution to wave length
196. BaSO4 is the least sol compound
197. Base of supp must not melt below 30 C
198. "Association (amphophilic) colloids: aq, non aqueous medium, lipophilic and
hydrophilic
199. parts in disperse particles, form aggregates at CMC.. Micelle concentration inc:
viscosity inc ,,
200. addition of electrolytes:: pptn"
201. "Aq. Antioxidents: ascorbic acid, sod. Metabisulfite, sod, bisulfite, sod. Sulfite --
indirect
202. antioxident: EDTA"
203. Antioxidants: ascorbyl palmitate, butylated hydroxy anisole (BHA), ethylene
diamine, K metabisulfite, Na metabisulfite, Na bisulfite
204. Anions SAA are compatible with icthamol ans econazole nitrate
205. Anionic surfactants are compatible with econazole nitrate, icthamol
206. Anionic surfactant like Na lauryl sulfate is compatible with icthamol
207. Anionic surfactant is compatible with icthamol
208. Anionic SAA is compatible with econazole nitrate and icthamol ex: Na lauryl
sulphate
209. An ointment base is made of hydrocarbons
210. Ampicillin and insulin are stored at 2-8 C but not freezed
211. Amaranth is a coloring agent
212. Amaranth is a coloring agent
213. Aluminium chloride is antiprespirant
214. Aloes sunscreen oils protect from UV
215. AlCl3 is locally applied antiprespirant because it precipitates proteins and dec
excretion
216. Al in Rx is used as astringent
217. Adsorption is a physical phenomenon
218. Adsorption is a physical phenomenon
219. Acacia is sol in H2O and insol in alcohol
220. A unit dose package: one that contains the exact dose of drug ordered for a
given pt
221. 65% sucrose: # microbial growth
222. 3-coarse dispersion: (greater than 0.5 micron) visible, pass nothing, ex:
emulsion, suspension
223. 0.1% clorohexidine HCl, the emulgent is cetrimide
224. % of chlorocresol is 0.05 - 1 %
225. Starch used as disintegrant
226. Simethicone is silicone derivative
227. Cellulose acetate phthalate used in enteric coated tablets
228. Autoclaving(3 Q's)
229. Which of the following base should be used for the hydrocortisone cream?
230. There were questions on pH and solubility of the drug For example if we
alkalanise the pH then which of the following drug will be excreated?
231. How does the uv rays kill microorganism? a. by change in dna structures
232. Why KCL is given as sustained release dossage form?
233. What is used to form enteric coated tablet? Cellulose acetate phethalate
234. What is the least appropriate drug to be crushed before sollowing? Aspirin-
indoethacin- Omeprazole- Rantidine
235. Ointment base: a)cannot be mixed with water b)monophasic
236. How is a bitter taste masked?a) Sugar...b) Film...c) enteric and sugar..d) sugar
and film..e) film and enteric
237. Creaming of emulsion directly proportional to the difference in specific gravity
between the 2 phases
238. What will affect the dose of a transdermal patch.a) the serum concentration of
the drug will decrease as soon as the patch is removed b) absorption can be different on
different skin parts of the body.c) absorption depends on the nature of the drug
(lipophility)..d) humidity can affect the absorption
239. To move the drug from low concentration to high concentration: - we need to
increase partition coefficient - it need energy and specific carrier
240. Sunscreen ingreditent: titanium dioxide
241. Shelf life of opened Eye drops? → 28days
242. Parafin liquid - hydrolalphitic carbon... immiscible with alcohol and castor oil
243. Which is not true regarding alkaloids? PKa less than 7, soluble in alcohol,
sparingly sol in water
244. Which Barium salt is soluble in stomach acid?
245. Tragacanth is a gum
246. Rapid onset of action for sublingual route of administration
247. Question about transdermal patches select wrong answer? Depends only on
nature of drug content
248. Ph affects absorption rate
249. Particle size for suspensions
250. O/W emulsion: cetostearyl alcohol is the surfactant
251. O/W emulsion which base? SLS - Sorbitan oleate
252. Na phenobarbital in aqueous solution becomes alkaline
253. Hydrophilic oint. Is (adsorption base-water removable-water soluble)
254. HLB values for o/w emulsion
255. Fats, oils and powders are sterilized at 160c for 2 hours
256. Dithranol paste with ZnO and 2% salicylic acid
257. Why KCL is given as sustained release dossage form?
258. Which is not included in tablet testing.....Ans. Tablet Uniformity
259. Which drug needs to be in tightly closed container (having high vap pressure)
260. What will affect the dose of a transdermal patch a) the serum concentration of
the drug will decrease as soon as the patch is removed b) absorption can be different on
different skin parts of the body c) absorption depends on the nature of the drug
(lipophility) d) humidity can affect the absorption
261. What is used to form enteric coated tablet? Cellulose acetate phethalate
262. What is not true for alkaloids… PH less than 7
263. Vehicle in ophthalmic (PVA)
264. To move the drug from low concentration to high concentration: - we need to
increase partition coefficient - it need energy and specific carrier
265. Sunscreen ingreditent: titanium dioxide
266. Storage 2 to 8 for what… all opthalmics drops and sulphonamide suspension.
267. Potassium permanganate 2% dispensed 300ml, doctor want to give dose as
1:1000 using measure of 50ml. -dilute 5o ml to 1L water
268. Parafin liquid - hydrolalphitic carbon - immiscible with alcohol and castor oil
269. Ointment base: a)cannot be mixed with water b)monophasic
270. Moist heat sterilization is better than dry heat.
271. How is a bitter taste masked?a) Sugar b) Film c) enteric and sugar d) sugar and
film e) film and enteric
272. Drug absorption is mainly passive absorption.
273. Decompose by heat sterilization: procaine
274. Creaming of emulsion directly proportional to the difference in specific gravity
between the 2 phases
275. Bioavaiabiliy determinent in regular immidiate release tablet? Dissolution -
dissintegration- metabolism
276. To measure 25 U of 100 U insulin use a special 100 U syringe which has a max
capacity of 50 U
277. The best emergency advise for pt with minor burn is to immerse the burn in cold
water until no pain is experience either in or outside the water
278. Rectal temp is about 1 DF above oral temperature
279. Radial artery: mesure pulsation
280. Na nitroprusside, KCl: slow IV infusion --- diazoxide: rapid bolus IV
281. IV inj: phlebitis, vein inflammation
282. Hypodermoclysis: the intentional administration of IV fluids into SC tissue
283. Barium bisulfate is used to X-ray GIT orally or rectally
284. Spans = sorbitane esters
285. Dithranol is used for ttt of psoriasis topically, better stabilized in pasts of ZnO by
adding 2% salicylic acid
286. Antibacterial action of phenol increase by increasing temperature
287. What is the least appropriate drug to be crushed before sollowing? Aspirin-
indoethacin- Omeprazole- Rantidine
288. Interaction of SLS and cetylpyridinium Cl … incompatible
289. 0.9% NaCl injection makes penicillin more stable
290. Upon exposure to air, aminophylline soln may develop crystals of theophylline
291. Atropine does not decompose by heats

CHF recalls

1. There is no digoxin loading dose


2. The most common SE of digoxin is GIT disturbances
3. The aortic and pulmonary valves prevent the backflow of blood to the ventricles
4. Systole= heart contraction
5. Orthopenea: dyspnea on lying, relief on standing
6. Most common SE of digoxin is GIT
7. Mechanism of digoxin is bound to Na/K ATPase pump
8. Major determinant of myocardial O2 consumption in cardiac output
9. Left side heart failure leads to dyspnea
10. K is used with digitalis to avoid toxicity
11. K is used with digitalis to avoid toxicity
12. Interaction of digoxin and K: hypokalemia or drugs that cause hypokalemia may lead to
cardiac arrhythmia - hyperkalemia reduces therapeutic effect of digoxin
13. Inotropic action of B stimulants of cardiac muscle is increased any in Ca entry
14. If pt's symptoms are dyspnea, sweating: diagnosis is heart failure
15. Hypokalemia inc digoxin toxicity
16. Heart failure + lignocaine= inc lignocaine level due to low hepatic blood flow thus
decrease lignocaine clearance
17. Erythromycin, verapamil, diltiazem are C.I. with digoxin
18. Dose of digitalis is 0.125 - 0.25 mg daily
19. Dopamine is first choice in ttt of emergency hypotensive shock
20. Dobutamine is a B-agonist that is available for IV use as inotropic agent. Although
dobutamine is similar to isoproterenol in terms of inotropic effects, dobutamine is
realtively less potent than isoproterenol as a stmulator for peripheral B-receptors
21. Digoxin soft gelatin capsules give greater bioavailability than tablets
22. Digoxin soft capsule provides better bioavailability than tablets
23. Digoxin is cheifly excreted unchanged by kidney
24. Digoxin dose must be reduced in elders as they have low renal function
25. Digoxin absorption dec by kaolin and cholestyramine and neomycin and erythromycin
and tetracyclin
26. Digoxin # Na-K ATPase
27. Digitoxin: hepatic clearance --- digoxin: renal clearance
28. Digitoxin metabolism: bound to serum albumin in liver -- digitoxin is best oral form and
used in renal impairment because it is excreted by liver
29. Digitoxin is more lipid slouble than digoxin
30. Digitalis is C.I. with Ca (displaces K: toxicity)
31. Digitalis + furosemide + K -- we use K to decrease digitalis toxicity
32. CHF inc creatine phosphokinase (CPK)
33. "Ca is contraindicated with digitalis because both increase contractility of the heart
which
34. may lead to arrythmia, also Ca replace K from myocardial cells, leading to digitalis
toxicity"
35. Amrinone : used instead of digoxin
36. 0.2 mg lanoxicaps (soft gelatine) = 0.25 mg digitoxin tablets in potency
37. (cont. dobutamine) that mediate vasodilation. Consequently dobutamine produces
inotropic effects with consequently little effect on preload, afterload or heart rate.
38. Blood fastest speed is in artrioles
39. Systole mean that ventrical contraction
40. Lisinopril maximum dose in mild heart failure: (2.5mg– 10mg – 20mg – 60mg)
41. Common side effect of digoxin: gastrointestinal disturbances
42. Question about right heart failure
43. Heart conducting system does not involve AV valve
44. Digoxin toxicity does not cause pulmonary edema
45. Blood flow is rapid in arteries
46. Patient is on Digoxin and sudden increase in Digoxin level. What is the possible reason?
Ans: Dig + Verapamil Drug Interaction
47. Dobutamine.........Used in HF.
48. Digoxin causes adverse effect in which condition: HypoK+
49. Common side effect of digoxin: gastrointestinal disturbances
50. Patient profile: Aspirin in CHF patient with asthma ( 4 to 5 questions)
51. Patient profile on digoxin toxicity and celecoxib (4 to 5 questions)
52. Intercation between Digoxin and Furosemide
53. Drug interaction Digoxn and furosemide
54. Amrinone:ttt of CHF direct mechanism --- amiodarone: antiarrythmic (K channel
blocker)-- amiloride : K-sparing diuretic
55. Cimetidine increase digoxin toxicity
56. Emergency minor burn advice: immerse burn in cold water
57. Diseases:: cooley's: familial erythroblastic -- down's: mongolism -- hansen's: leprosy --
herpes zoster: shingles -- alzeheimer: presentile dementia
58. Classifications::: thiothixene: antipsychotic -- protriptyline: antidepressant --
trimethadione: anticonvulsant -- oxazepam: antianxiety -- trimethobenzamide:
antiemetic -- isocarboxazide: MAOI -- HCTZ: diuretic -- tripelennamine: antihistaminic
0-1 month: neonates--- 1 month-1y: infants --- 1-5y: early childhood --- 5-12y: latechildhood
Constipation recalls

1. Safe laxative in pregnancy is methylcellulose


2. Phenolphthalin, castor oil used as intestinal irritant (stimulant laxative)
3. Ph.ph with mineral oil is used as intestinal irritant
4. Methylcellulose is a safe laxative in pregnancy
5. Metamucil: psyllium husk, inc dietary intake of fibers, used as laxative, dose is 7g tid,
must drink enough water with the tablet
6. LaxativesMOA::: Mg citrate, Na biphosphate: draw water into intestinal tract by osmosis
- - psyllium: bulk forming by absorbing H2O -- minerla oils: soften stool by lubrication --
Na docusate: soften stool by dec serface tension --
7. Dulcolax tablets: should be taken whole and not broken or chewed - because they are
enteric-coated to prevent gastric irritation
8. Docusate Na is a SAA. It softens stools by stimulating intestine secretion. The effect is
usually given within 1-3 days after oral administration or 2-15 minutes following rectal
administration.
9. Dioctyl Na sulfosuccinate = docusate=stool softener (anionic surfactant)
10. Colace: do not take with mineral oil -- Colace is a surfactant and may increase the
absorption of mineral oil if given concurrently
11. Ca polycarbophil : ttt of constipation
12. Bulk-forming laxatives: psyllium, methylcellulose, bran, polycarbophil
13. Bulk laxatives:: psyllium, methylcellulose, Ca polycarbophil
14. Bulk forming laxatives are used safely in pregnancy like; psyllium, methylcellulose, bran,
polycarbophil or stool softener (Na docusate)
15. Al(OH)3=constipation
16. Al causes constipation
17. Contraindications for Psyllium?a) Hypokalemia b) Gallstones
18. Contraindications for Psyllium? a) Hypokalemia b) Gallstones c) Hyper-something

Corticosteroids recalls

1. The glucocorticoid with highest potency is dexamethasone


2. Release of glucorticoids is under the control of : circulating cortisone level in blood,
hypothalamus which release corticotrophin releasing factor by feed back mechanism.
3. Pt on dogoxin and HTCZ, most appropriate glucocorticoid is dexamethasone (no Na
content and no salt and water retention)
4. Prednisone, methylprednisolone, dexamethasone, betamethasone :: glucocorticoids
5. Prednisone oral = 4 times more potent than hydrocortisone IV so if a pt was given 50 mg
HC IV every 6 hrs it is equivalent to 50 mg prednisone once daily
6. Prednisone dose: 5-60 mg
7. Prednisolone shows higher activity than hydrocortisone because it differs in
conformation at ring A
8. Important complications of corticosteroids are: dissemination of local infection, inc
susceptibility to infection, masking symptoms of an infection
9. High cortisone intake may lead to moniliasis
10. High cortisone intake may lead to moniliasis
11. Glucocorticoids cause spread of infection
12. For corticosteroid creams put occlusive dressing: hydration of the skin with occlusive
dressing such as a plastic wrap, a tight fitting nappy or one covered with plastic pants,
plastic tape pr dermatological patches can increase penteration up to 10 folds

13. Fluorinated corticosteroid is C.I. in rosacea (chronis vasodilation on nose and cheeks
causing redness)
14. Fludrocortisone: high mineralo: ttt of addison's dissease
15. Cortisone causes osteoporosis
16. Corticosteroids: inc susceptibility to infection
17. Corticosteroids functions include all the following: intermediate in metabolism, salt and
water retention, muscle development, hemopoesis
18. Corticosteroid function: metabolism, salt and water regulation, muscle development,
hemaptosis
19. Comparing with hysrocortisone: prednisolone shows higher activity because it differs in
conformation at ring
20. (glucocorticoids) hydrocortisone (cortisol):: relative potency: 1, equivalent dose: 20mg,
Na-retaining potency: 2
21. (cont. glucocorticoids) prednisolone & prednisone:: relative potyency: 4, equivalent
dose: 5mg, Na-retaining potency: 1
22. (cont. glucocorticoids) methylprednisolone:: relative potency: 5, equivalent dose: 4mg,
Na-retaining potency: 0
23. (cont. glucocorticoids) dexamethasone:: relative potency: 30, equivalent dose: 0.75mg,
Na-retaining potency: 0
24. (cont. glucocorticoids) cortisone:: relative potency: 0.8, equivalent dose: 25mg,
Naretaining potency: 2
25. (cont. glucocorticoids) betamethasone:: relative potency: 25, equivalent dose: 0.6mg,
Naretaining potency: 0
26. WHICH MEDICATION LESS LIKELY TO CAUSE COLD: PREDNISOLONE
27. patient on corticosteroids develops rash on face due to telangiectasias and striae-
stevenjohnson
28. Glucocorticoids long-term use causes osteopenia
29. Which medication less likely to cause cold: prednisolone
Cough recalls

1. Receptors of cough occur in medulla in the brain stem


2. Expectorant dose of ipecac syrup for adult is 1ml
3. d-methorphan is 1st choice for routine cough suppression
4. Cough reaction: receptors in respiratory tract and receptors in stomach
5. Bromohexine: depolymerization of mucous
6. Bromhexine , acetyl cystiene are mucolytics
7. Acetyl cysteine is mucolytic used by inhalation
8. Acetyl cystein is administered by inhalation
9. 5-carboxymethylcysteine=acetylcysteine is mucolytic, ttt of mucous gland hyperplasia

Cystic fibrosis recalls

1. Ttt of cystic fibrosis: dornase alpha, N-acetylcysteine, pancreatin


2. Cystic fibrosis is heriditary not contagious characterized by secretion of viscous sticky
mucous from lungs and pancreas
3. Cystic fibrosis is heriditary NOT contageous characterized by secretion of viscous, sticky
mucous from lungs, pancreas, ttt pulmonase, alpa-dornase
4. Cystic fibrosis is hereditary related to parents
5. Cystic fibrosis is hereditary related to parents
6. Cystic fibrosis is a heridetary disease of exocrine glands affecting GIT, respiratory
system, usually characterized by COPD, exocrine pancreatic insuffeciency, abnormally
high sweat electrolytes, pseudomonas infection is the dominant infection..
7. Cystic fibrosis is a genetic disease: both parents must have the genes for it
8. In cystic fibrosis there is change in sweat
9. In cystic fibrosis both parents have recessive gene
10. What is the diagnostic test for cyctic fibrosis? FEV1 ratio ..Amount of chloride in sweat
etc......
11. In cystic fibrosis which shows elevated levels (alkaline phosphatase, amino acid)
12. In cystic fibrosis which ion inc. Cl-
13. Cystic fibrosis: both the parents have recessive gene
14. Cystic fibrosis replacement therapy?

Cytology recalls

1. Xanthine, uric acid, and adenines are purines # 6-MP


2. Xanthine, uric acid, adenine all are purines
3. rRNA: 80% -- t-RNA: 15% -- m-RNA: 5%
4. Ribosomes are attached to the endoplasmic reticulum (rough endoplasmic reticulum)
5. Ribosome is composed of aminoacids
6. Ribosome is composed of aminoacids
7. Ribosome is composed of amino acids
8. Pyrimidines: C, T, U
9. Purines: A, G
10. Nevirapine: non nucleoside reverse transcriptase inhibitor (NNRTI)
11. "Kreb's cycle in mitochondria for respiration -- glogi apparatus: stores (plasma,
lysosymes
12. syn.) --- lysosymes: contain digestive enzymes -- smooth ER: lipid syn --- rough ER:
protein syn"
13. RNA that has a specific aminoacid attached.. trna
14. ER has attached what.. ribosome
15. Metabolism of drugs occurs in the subcellular organ in the endoplasmic
reticulum,ribosomes

Depression recalls

1. With MAOI can take red meat BUT NOT wine, beer, cheese, chicken liver
2. Trazodon: TCA with least anticholinergic SE
3. Trazodon is TCA with least anticholinergic SE
4. Tranyl cypromine is MAOI antidepressant
5. Theophyllin dec Li
6. The onset of TCA requires 3-4 weeks
7. TCAs should not be used in pts also taking: guanthidine - TCAs such as imipramine and
amitriptyline may block the uptake of guanthedine by adrenergic nerves, thereby
inhibiting its antihypertensive action.
8. TCAs are contraindicated in glucoma and it cause sedation and anticholinergic side
effects
9. TCA SE = sedation, anticholinergic
10. TCA is C.I. with guanthedine
11. TCA is C.I. with guanithidine
12. TCA increase the action of MAOI - antidepressants : TCA , MAOI , alpha blockers -tranyl
cypromine is a MAOI - amphetamine , phenyl ephrine , ephedrine, tyramine + MAOI =
hypertensive crisis
13. TCA increase action of MAOIs
14. TCA dec active reuptake of seretonin, norepinephrine
15. TCA affect neural amine reuptake mechanism
16. TCA # reuptake I of NE, 5HT
17. Tachycardia is the SE of TCA
18. Sibutramine: # reubtake of NE, S, D
19. Sertraline is SSRI, also fluoxetine
20. Sertraline is SSRI
21. Sertraline is hepatotoxic
22. SE of MAOI is tachycardia
23. SE of MAOI is tachycardia
24. SE of cyclobenzaprine is similar to amitriptyline --- cyclobenzaprine is a central skeletal
muscle relaxant structurally related to TCAs
25. SE of antidepressents: antimuscarinic effects, constipation, posural hypotension,
drowsiness, but venlafaxine cause HTN
26. SE of amitriptyline: dry mouth, constipation, blurred vision
27. SE of amitriptyline are: constipation, dry mouth, blurred vision, drowsiness
28. Red meat is NOT C.I. with MAOIs
29. Red meat in NOT C.I. with MAOIs
30. Pts on Li therapy should not restrict Na intake
31. Pt taking tranylcypromine should restrict diet and drugs
32. Pseudoephedrine should be taken with caution with Iproniazid
33. Pseudoephedrine is used with caution with Iproniazid
34. Procarbazine is MAOI requires dietary percautions
35. Procarbazine is MAOI
36. Phenelzine: MAOI, not taken with tyramine
37. Patients taking Li carbonate is advised not dec Na intake -- Li is C.I. with
naturetics/diuretics
38. Pargyline:: do not ingest aged cheese, beer or chianti wine -- food and beverages
containing significant amount of tyramine must be avoided by individuals taking MAOIs
such as pargyline because of hepatic MAO inhibition, ingested tyramine will
39. Nefazodone: # 5HT reuptake, inc 5HT-- SE: hepatic failure, C.I. with cisapride, TCA,
MAOIs, terfinadine, astemizole
40. MAOIs in C.I. with guanithidine
41. MAOIs are : psychotropics, antidepressants, antileptics -- SE: hallucinations, tremors,
hyperthermia, anticholinergic SE., dry mouth, constipation, failure of ejaculation
42. MAOI SE is NOT tachycardia BUT it is the SE of TCA
43. MAOI are C.I with guanthidine
44. MAOI + cheese=cheese reaction=hypertensive crisis due to tyramine content which
increase norepinephrine concentration
45. MAOI : tranylcyromine, phenelzine, meclobimide, iproniazide
46. Lithium causes nephrogenic diabetes insipidus ttt by vasopressin
47. Li: ttt of severe bipolar manic depression psychoses --- SE: D. insipidus
48. Li therapy cause diabetes insipidus
49. Li SE: diabetes insipidus, hypothyrodism?, convulsions
50. Li is used in bipolar affective disorder
51. Iproniazide : MAOI antidepressant used with caution with other TCAs any food
containing tyramine, levodopa, sympathomimetic amines, pithidin, rawoulfia alkaloids-
dec action of adrenergic neuron blockers - inc action of oral hypoglycemic
52. In dipolar mood disturbance: Li, carbamazepine, Na valproate
53. Imipramine is TCA used for enuresis and hyperkinetic child
54. Imipramine is metabolized by demethylation giving desipramine
55. Imipramine (tofranil): enuresis
56. Hypertensive crisis caused by tyramine+MAOIs is ttt by alpha blocker like phentolamine
57. Glutithimidine is MAO inducer
58. Fluoxetin does not cause hepatotoxicity
59. Early expected effect of amitriptylene is very sleepy sensation, very dry mouth, and no
progress in depression
60. Doxipen: TCA
61. Clomipramine is used in occlusive depression disorder
62. Chlorothiazide is C.I. with amitriptylline (TCA)
63. Carbamazepine: anticonvulsant -- trazodone: antidepressant -- molindone:
antopsychotic -- alprazolam: antianxiety -- isocarboxazide: MAOI -- amiloride: K-sparing
diuretic -- clemastine: antihistaminic -- diltiazem: CCB -- sulfinpyrazone: uricosuric
64. Bipolar depression can be ttt by: Li, carbamazepine, SSRI, Na valporate BUT NOT
haloperidol
65. Bicyclic antidepressants; viloxine -- TCA: maprotiline, menserine
66. Aspirin does NOT interact with MAOI
67. Antidepressants: amitryptilline, SSRT, NSRI, linezolide, tranylcypromine, phenelzine,
meclobemide, razodone, trazodone
68. Antidepressants : TCA , MAOI , alpha blockers
69. Amphetamine , ephedrine , phenyl ephrine + MAOI = hypertensive crisis
70. Amitriptylline: ttt of depression with anxiety
71. Amitriptyline(TCA) is used for deep visceral pain ans post operative neuralgia - TCAs esp.
amitriptyline, clomipramine, doxipen, imipramine, nortriptyline, and trimipramine are
used in pts with normal or depressed mood,
72. Amitriptyline (TCA) used in the ttt of deep visceral pain, post operative neuralgia
73. Amitriptyline # chlorothiazides
74. (cont. TCA) and for the management of chronic, severe pain as in cancer; migraine and
chronic, daily muscle contraction headaches; rheumaric disorders; atypical facial pain;
post herpetic neuralgia; and diabetic or other peripheral neuropathy
75. (cont. MAOI, tyramine) escape its normal deamination and release excessive amount of
norepinephrine from storage granules at nerve endings. The resultant hypertensive
crisis will lead to headache, fever, and sometimes death due to intracranial bleeding
76. Paroxetine never used in bipolar disorders
77. Which one is not antidepressant: quetiapine
78. Tranylcypromine: irreversible non-selective MOA inhibitor
79. S.e of paroxetine: (gynecomastia and sexual dysfunction)
80. Which food can be taken with MOIS- beer- red wine- chicken liver - red meat
81. Which Antidepressant causes Hypertension? Venlafaxine
82. TCA's MOA: affects uptake of amines
83. MAO A inhibitors: Moclobemide
84. Imipramine - Fluoxetine for nocturnal enuresis
85. Which is not antidepressant: haloperidol (asked twice: the second one had different
option: quetiapine)
86. Which food can be taken with MOIS - beer - red wine - chicken liver - red meat
87. Which Antidepressant causes Hypertension? Venlafaxine
88. Tranylcypromine: irreversible non-selective MOA inhibitor
89. S.e of paroxetine: (gynecomastia and sexual dysfunction)
90. Nortryptyline ADR
91. Adverse effect of nortyptiline (constipation)
92. The onset of TCA requires: 3-4 weeks
93. Oral anticoagulant + imipramine = increase action of imipramine
94. Adverse effect of TCA (constipation)
95. Trazodon + MAOI = serotonin syndrome --- L-dopa + MAOI = hypertensive crisis ---
methylphenidate + MAOI = potentiate CNS stimulation (2 weeks elapse)
96. Antihypertensive effect of guanethidine in inhibited by TCAs (amitriptyline)

Dermatology recalls

1. Use of siver sulfadiazine, mafenide is topically for burns and wounds


2. Retinoic acid is used therapeutically to accelerate production of epithelial ceels in the
skin
3. Podophyllum resin for ttt of warts
4. OTC# lice: pyrethrins, piperonyl butoxide, petrolatum distillate --- RX: cretamiton
5. Mite cause scabies
6. Minocyclin is used in ttt of acne vulgaris and its SE are NVD, vestibular toxicity
7. Hydrocotisone : ttt of rosacea NOT isotretinoin
8. Epidermis is keratin
9. Doxycyclin (vibramycin) : ttt of acne
10. Benzylperoxide gel : should not come in contact with eye or mucous membrane
11. Benzoylperoxide (antiacne)= should not come in contact wirh eye or mucous membrane
12. Al(OH)3 = abrasive removes comedone
13. Acne vulgaris is made by bacterial inflammation
14. Acne vulgaris is caused by bacterial infection: propionibacterium acne
15. What is the most appropriate counselling advice would you give to the patient taking
Benzoyl peroxide cream?a. avoid contact with hair..b. it can cause stain on coloured
cloths
16. In impetigo, which is wrong:it can complicate to endocarditis
17. Which one is a skin condition? All options were incorrect like. OA, RA, OP, Gout. One
left.....which was correct
18. Some skin conditions and symptoms......which is tht... is tht a drug allergy, stven jhonson
syndrome or anything else?
19. Counselling of benzoylperoxide (applied twce weekly, may stain yellow, skin peeling and
irritation may occur)
20. Coal tar should not be used for some UV treatment. Becoz it causes photosensitive.
21. Acne....name of the organism
22. Tazarotene: ttt of acne, psoriasis
23. Hydrocortisone is NOT suitable for ROSAISIA

Diabetes recalls

• When insulin is used as IV infusion with D5W during surgery it may be adsorbed on the
bottle and tubing
• Urine retention is NOT likely in DM which leads to polyuria
• Trypsine and lipase inc in pancreatic disease
• Tolbutamide: totally metabolized to an inactive form
• Tolbutamide is totally metabolized to inactive form
• Tolbutamide is an oral hypoglycemic
• Tolbutamide and fenformin have increased risk of cardiovascular disease ??
• Tolazamide: more slowly absorbed than other compounds(tolbutamide, acetohexamide,
chlorpropamide, phenformin)
• Tolazamide is slowly absorbed than other compounds
• The sliding scale (or rainbow scale) is a method of determining insulin dosing based on
periodic determinations of glucose and ketones in the urine. The physician prescribes
the regular insulin dosage as a function of the number of pluses (+) determined
• The parameters of significance in the glucose tolerance curve: 1-the peak conc of
glucose in blood 2-the time required for this peak to occur 3-& the rate at which the
blood glucose level declines with time
• The only insulin that can be given intravenously is crystalline (regular) zinc insulin
• The only insulin preparation that can be given IV is crystalline Zn (regular) insulin. It is
used in situations when rapid onset and brief duration of action is desired. It's so used
for the ttt of diabetic ketoacidosis, in this emergency situation
• The most common cause of diabetic ketoacidosis and coma is failure of pt to utilize
insulin
• The most common cause for diabetic ketoacidosis and coma in the diagnosed and
treated diabetic is failure of the pt to utilize insulin properly.. Diabetic ketoacidosis is a
direct result of the lack of insulin. the omission of insulin doses
• The most appropriate method to measure a 25U dose from a U100 insulin: use a special
U100 syringe that has a maximum capacity of 50U, it is commercially available, the
syringe is approximately the same length as the 1ml-100U syringe
• Tes-Tapes:: does NOT give a false +ve test for glucose in the urine of pts taking cefoxitin
(mefoxin) (NOT: benedict's soln, fehling's soln, clinitest)
• Tes-tapes: measure glucose in blood or urine
• Test fot presence of glucose: reagent strips impregnanted with glucose oxidase,
peroxidase, orthotolidine, are dipped into urine or blood; reaction is: glucose is oxidized
to gluconic acid, H2O2, the H2O2+ peroxidase+ orthotolidin= blue substance
• Symptoms of hypoglycemia: sweating, tachycardia
• Sulfonylurea MOA: stimulate insulin secretion
• Sulfonylurea mechanism of action:: stimulate insulin secretion
• Regular insulin=lispro insulin its duration of action is less than 12 hrs
• Protamine Zn insulin, logest duration, 24-36 hrs -- regular insulin, shortest duration, 6-8
hrs.
• Protamine Zn insulin has duration of action on 36 hrs
• Protamine zinc insulin has the longest duration of action =36hrs
• Proinsulin is the insulin impurity commonly used to compare the relative purity of
various insulins. Insulin purity is inversely proportional to proinsulin contamination,
which also reflects the relative concentrations of other non-insulin impurities
• Proinsulin (86aa`) is insulin impurity most commonly used to compare the relative purity
of the various insulin products
• Polydipsia=escessive thirst
• Phenformin: was indicated for obese diabetics whose hyperglycemia is due to
ineffective insulin action
• Patients with mature once DM can be ttt with tolbutamide and diet
• Pancreatitis is characterized by inc amylase level
• Normal insulin secretion : 50U/day
• Normal glucose is 80-120 mg%
• Normal blood sugar concn in fasting adult is 100mg/dl
• Normal blood glucose level: fasting=100-110mg/dl or <6.1mmol/L -- random=70-
126mg/dl or3.9-6.9 mmol/L
• Mixture of regular insulin and protamine zinc insulin (PZI) in a ration less than 1:1 would
be expected to have about the same duration of action as PZI because XSS protamine
will bind to regular insulin and convert it to PZI
• Metformin, phenformin are biguanides
• Metformin is preferred in obese diabetic pt whose hyperglycemia is due to ineffective
insulin action
• Metformin : biguanide
• Long-acting insulins such as PZI and ultralente are use in a relatively few pts because
they provide insulin concns too low to handle acute glucose challengesrelated to meals;
they also produce relatively high concns at night
• Long acting insulins such as PZI and ultralent used in a few pts because it provide insulin
concns too low to handle acute glucose levels related to meals and also produce inc
insulin concn at night
• Lente insulin : 70% crystalline (ultralente) + 30% amorphous (semilente)
• Insulin Zn suspension has duration 18-24 hrs
• Insulin will remain stable at room temperature during the time period in which single
vial will be used
• Insulin secretion: K level drop during glucose utilization
• Insulin secretion: K level dec during glucose utilization
• Insulin secretion dec K level in blood
• Insulin purity: content of proinsulin
• Insulin lente= 70%ultralente(crystaline) + 30% semilente (amorphous)
• Insulin lente:24hrs --- insulin protamine Zn=36hrs
• Insulin lente: 30% amorphous, 70% crystalline
• Insulin lente: 24hrs --- insulin protamine Zn: 36 hrs
• Insulin lente same as monotard same as insulin Zn suspension = 18-28 hrs
• Insulin lente actes for 24 hrs
• Insulin is a polypeptide hormone
• Insulin inc entering of glucose, fat and amino acids
• Insulin does NOT suppress syn of TG --- it stimulates its formation and storage
• Insulin does not suppress lipolysis
• Insulin does NOT dec syn of TG
• Insulin and glucagone are adsorbed on IV tubing
• Insulin administration is subcutaneous
• Iletin II contains <,=10ppm proinsulin and is available as a single species product (either
prk or beef)
• Ibuprofen increase hypoglycemic effect of insulin -- propranolol increases hypoglycemic
effect of insulin
• Hypoglycemia: tachycardia, sweating --- hyperglycemia: acetone odor in breath, ketones
in urine
• Hypoglycemia: tachycardia, sweating --- hyperglycemia: acetone odor in breath, ketones
in urine
• Hypoglycemia: complication most likely to occur after sudden discontinuation of
parentral hyperalimentation (composed of amino acids or protein hydrolysates, glucose,
electrolytes and vitamines
• Hypoglycemia may be induced after stopping of hyperalimentation (consists of amino
acids, glucose, electrolytes or vitamins)
• Hypoglycemia does NOT cause acetone mouth which is caused by hyperglycemia
• "Glucose tolerance is impaired by thiazides. Hyperglycemia induced by thiazides in
• unimportant in pts with normal carbohydrate tolerance but may intensify the
hyperglycemia in
• diabetics or precipitate glycosuria in persons predisposed to diabetes"
• Glucagon inc glucose level by inc hepatic gluconeogenesis, glycogenolysis
• Glucagon (SC, IM) used in the ttt of acute hypoglycemia when glucose administration is
not available
• For insulin dependent pt with HTN: atenolol is the best B-blocker that could be used
(selective and most hydrophilic)
• Duration of action of Lente insulin is 24 hours
• DM problems: cataracr, renal failure, CV disease, peripheral neuropathy
• Diuresis is a symptom of hyperglycemia
• Diabetics have highest risk of erectile dysfunction
• Diabetes has higher risk of erectile dysfunction
• Currently, all commertially available insulin no more than 25ppm proinsulin
• Compared with the normal glucose tolerance, the blood glucose versus time curve of a
diabetic has: a higher peak that occurs later and decrease more slowly
• Chlorpropamide is given once daily ( hypoglycemic )
• Chlorpropamide is given once daily
• Amylase level is raised in pancreatitis
• Amylase level inc in pancreatic disease
• Amphotricin B, Li, may cause D. insipidus
• Acetohydroxiamide acid is used as adjunctive therapy for UTI
• Acetohydroxamide acid (AHA, Lithostat) has been approved for as adjunctive therapy
for UTIs. AHA # bacterial urease enzyme so dec hydrolysis of urea to ammonia and
resultant alkalinity in chronic UTIs due to urease-producing organisms such as Proteus
• Acetohexamide: reported to have significant uricosuric properties, metabolized to
compounds having equal or greater hypoglycemic activity.
• Acetohexamide is oral hypoglycemic , have uricosuric effect
• Acetohexamide (oral hypoglycemic) have uricosuric effect and its metabolites have also
hypoglycemic effect
• Acarbose # alpha-amylase thus inhibit digestion of complex polysaccharides, acarbose
also inhibits alpha-glucosidase thus inhibit digestion of oligosaccharides
• 1st symptom of DM is excessive thisrt
• (Lilly's Iletin I,II insulin): Iletin II is more purified than Iletin I. Iletin I is a beef/pork
mixture. Iletin II is either beef of pork insulin. Iletin I contains <,=20ppm proinsulin and is
available as beef (70%)-pork (30%) mixture.
• (continue insulin syringe) but has a smaller inside-diameter and consequently will have a
capacity of 0.5ml, it is calibrated in a 1U increment to a max of 50U, that syringe makes
it possible for pt to measure small amounts accurately
• (cont. Tes-Tape) the glucose oxidase test for the presence of glucose in the urine is
apparently not affected by cephalosporins
• (cont. Tes-Tape) it is well documented in the literature that cephalosporin antibiotics
may cause false positive readings with Cu reduction tests.
• (cont. Tes-Tape) although Cu reduction methods (e.g. Clinitest) are more quantitative
measures for glucosuria than are glucose oxidase tests (e.g. Tes-Tapes) they are less
specific for glucose.
• (cont. Tes-Tape) a diabetic pt has been taking cefaclor 500mg p.o. q8hrs for UTI. To
determine whether this drug is interfering with the pt's urine glucose testing, a sample
of urine is tested by both Clinitest and Tes-Tape methods, the results are:
• (cont. Tes-Tape) 1% with Clinitest and 0.25% with Tes-Tape. Conclusion: a false positive
result with clinitest
• (cont. sliding scale) since the sliding scale is generally used to determine the 24hr insulin
requirements of a ketonic diabetic, the modified insulins (e.g. NPH) are not use, but
regular insulin is the one used.
• (cont. sliding scale) by the copper reduction (Clinitest) glucose determination and the
presence of urinary ketones, he amy prescribe a number of U for each + (e.g 4U for each
+) or more variable schedule.
• (cont. regular insulin) the drug is often used in conjunction with
subcutaneouslyvadministered longer acting preparations
• (cont. proinsulin and insulin purity) such as glucagone, somatostatin, pancreatic
polypeptide. Currently, all comercially available insulins contain no more than 25ppm of
proinsulin
• (cont. glucose tolerance curve) in a diabetic pt, the blood glucose peak is higher, occurs
later and declines more slowly than a corresponding blood glucose curve for a normal
individual
• (cont. diabetic ketoacidosis) or errors in adjusting the insulin dosage in response to
changes in food intake of physical activity is probably the most common cause of
diabetic ketoacidosis. Other common causes include infections and myocardial
infarction
• Action of insulin glagrine is glucose utilization by tisues
• Which of the following will have higher hypoglycaemic
effect?Metformin.Rosiglitazone..Glipizide..insulin
• Which of the following has the possible sideeffect of
lactoacidosis?Metformin..Pioglitazone..Glibenclamide Insulin
• Which of the following is a risk factor for cardiovascular diseases?a) low LDL b) High HDL
c) Ratio of total Cholesterol to HDL <3.5 d) Diabetes
• Insulin increases glucose uptake
• Select wrong answer regarding diabetic foot problems? Options regarding causative
organisms and dressings
• Lactic acidosis is common with metformin
• Acarbose maximum dose: 600mg/day
• Which of the following is a risk factor for cardiovascular diseases? a) low LDL b) High
HDL c) Ratio of total Cholesterol to HDL d) Diabetes
• Normal fasting blood glucose level....Ans. 3-6mmol/L
• MOA of Insulin.....Ans. Increase glucose uptake.
• Insulin overdose .......symptoms.
• Insulin increases glucose uptake
• Doses: repaglinide
• Aspirin increases the hypoglycemic effect of tolbutamide by plasma protein
displacement- aspirin decreases the uricosuric effect of probenicid

Recalls of Diarrhea
1. Toxic effects of clindamycin may be inc when used with lomotil
2. Metronidazole is C.I. with alcohol
3. Metronidazole is C.I. with alcohol
4. Loperamide: antidiarrheal, if given to a pt with ulcerative colitic it will produce intestinal
perforation
5. Lomotil should not be taken with clindamycin because toxic effects of clindamycin may
be enhanced
6. Lomotil should not be given to pts taking oral clindamycin or lincomycin because toxic
effects of clindamycin or lincomycin will be enhanced
7. Lomotil (diphenoxylate + atropine) does NOT cause bronchospasm and atropine dec the
likelihood of opiate abuse
8. Lomotil (diphenoxylate + atropine) does not cause bronchospasm
9. E-coli: traveller's disease, treated by bismuth subsalicylate
10. Diphenoxylate is related to mepiridine, it stimulates opiate center in GIT causing
constipation
11. Dipenoxylate is related to meperidine and activate opiate center in the GIT leading to
constipation
12. Citrate is in oral rehydration, used to compat alkalosis and to improve salty taste of the
solution
13. Citrate in oral rehydration is to compete alkalosis
14. Bi subsalicylates: prevent and ttt of travellers diarrhea --- ttt: TMP-SMZ, doxycycline,
quinolones
15. Avoid metronidazole with alcohol = disulfiram like reaction
16. An advantage of loperamide over diphenoxylate as an antidiarrheal is the fact that
loperamide does not appear to have opiate-like effects. Loperamide is a schedule V
controlled substance.
17. Advantage of loperamide over lomotil as antidiarrheal is that loperamide dose not have
opiate like effects
18. (cont. loperamide) it inhibits peristaltic activity by direct effect on musculature of the
intestinal wall. It appears to be devoid of opium-like effects
19. (cont. loperamide) even after chronic administration of loperamide, the injection of
narcotic antagonist naloxone does not produce pupillary dilatation
20. (cont. clindamycin, lincomycon vs. lomotil) antimobility drugs (e.g. diphenoxylate) used
to treat resulting diarrhea seem to prolong desease so they should not be used
21. (cont. clindamycin, lincomycin vs. lomotil) the inflammatory conditions of the colon (e.g.
nonspecific colitis or more severe pseudomembranous colitis) has been associated with
antibiotic therapy
22. (cont. clindamycin, lincomycin vs. lomotil) colitis has been associated with oral and
parentral administration of these drugs and no clear predisposing conditions have been
identified
23. (cont. clindamycin, lincomycin vs. lomotil) although many antibiotics have been
implicated, there've been a disproportionate no of reports specifically involving
clindamycin and lincomycin
24. if a patient is given metronidazole what is the most appropriate counselling you would
provide?a. avoid alcohol..b. not more than 2 standard drinks...c. take with food
25. Oral Rehydation Solution Why addind Citrate?a) to mask the salty taste...b) against
acidosis...c) against alkalosis..d) provide nutrients
26. When can you take Diphenoxylate?a) Uncomplicated Diarrhea b) Antibiotics related
Diarrhea c) Chronic Diarrhea
27. Citrate in ors: against acidosis
28. Drug for travellers diarrhoea
29. When can you take Diphenoxylate? a) Uncomplicated Diarrhea b) Antibiotics related
Diarrhea c) Chronic Diarrhea
30. Oral Rehydation Solution Why addind Citrate? a) to mask the salty taste b) against
acidosis c) against alkalosis d) provide nutrients
31. Citrate in ors: against acidosis

Doses and drug interactions recalls

1. The usual dose of chlorhexidine is 0.02, 0.05%


2. Suitable elderly dose is 1/3-1/2 of the adult dose
3. Salbutamol dose is 2-8 mg daily --atropine dose: 0.25-2 mg -- chlorothiazide: 0.5-1 gm
4. Na nitroprusside, KCl: slow IV infusion -- diazoxide: rapid bolus IV
5. Methotrexate: intrathecal --- thiopental: IV, intrathecal
6. IV inf: saline, Na nitroprusside, vancomycin, KCl
7. Doses::: hydralazine:50-200mg -- carbamazepine:0.2-1.2g --methyldopa:0.5-2g --
colchicine:500mg -- prednisone:5-60mg -- aspirin (antiplatelet):75-150mg -- aspirin
(antigout): >5g -- chlorocresol: 0.05% -- captopril: 25-50mg -- phenytoin:50-400mg(max)
8. "Doses:: salbutamol:2-4mg or 10mg -- dithranol:0.1-1% (psoriasis) --chlorothiazide: 125-
9. 500mg or 1g --atropine: 0.25-2mg -- chloralhydrate: 0.5-2g --GTN:0.3-1.2mg --
cimetidine: 400-
10. 2000 mg -- ranitidine:150-300mg -- aspirin in RA:6g -- HCTZ:12.5,25,50mg"
11. Dose of aspirin in rheumatic fever: 6g --- dose of atropine: 0.2-2 mg --- dose of
chlorothiazide: 0.5-2g
12. Tyramine food is C.I. with: pragyline, phenelzine, isocarboxazide, tranylcypromine
13. Sodium thiocyanate affect iodine uptake
14. G6PD hemolytic anemia with:: aspirin, dapsone, primaquine, quinine, dimercaprol,
sulfonamides, chloramphenicol, nirofurantoin, nalidixic acid
15. Critical interactions: cimetidine + theophylline --- sulfonamides in neonates: inc
bilirubin: kernicterus
16. Cetrizine, terfenadine, astemizole:: # metabolism of ketoconazole, clarithromycin,
erythromycin
17. Interaction with st.Jones wart
18. Drugs causing hyperkalemia

Epilepsy recalls

1. When pt taking phenytoin has ataxia, he should reduce the dose


2. Vigabatrin is enzyme inducer that inc clearance of phenytoin,
carbamazepine,phenobarbital
3. Valproic acid is used for grandmal and petitmal epilepsy
4. ttt of epilepsy: diazepam, succinylcholine, phenobarbitone, NOT phenothiazines
5. Trigeminal neuralgia is a disorder characterized by sudden attacks of severe pain along
the distribution of the 5th cranial nerve, attacks are ofen precipitated by stimulation of
a trigger zone in the area of the pain.
6. The metabolism of folic acid is altered in pts taking in anticonvulsant drugs
7. SE of phenytoin: nystagmus, gingival hyperplasia, morbiliform rash (measles like), SLE,
ataxia, hirsutism, steven johnson syndrome
8. Phenytoin: has narrow therapeutic index, need TDM (therapeutic drug monitoring)
9. Phenytoin, diazepam, valproic, phenobarbital all are used in grandmal except
ethosuxamide which is DOC for petitmal epilepsy
10. Phenytoin should be taken with food to dec gastric irritation
11. Phenytoin SE: gingival hyperplasia, osteomalacia, hirsutism, ataxia
12. Phenytoin SE is gingival hyperplasia, ataxia, hirsutism
13. Phenytoin is taken as a single daily dose or as 3 divided doses
14. Phenytoin is not used in absence seizures
15. Phenytoin dose: 50-400 mg max? increment: 30mg once
16. Phenytoin can be used once daily and three times daily
17. Oral anticoagulant + diphenhydramine = increase anticonvulsant toxicity
18. Maximum dose of phenytoin is 300 mg
19. Jacksonian epilepsy is associated with focal convulsions
20. Jacksonial convulsion=focal convulsion.during it consciousness is often maintained.The
seizure can be motor, sensory or autonomic in nature.It usually begins in part of the
limb or face as a localized clonic spasm, then spreads in somewhat orderly fashion

21. In epilepsy GABA transmission is low ???


22. Grandmal epilepsy: Na valproate, phenobarbital, diphenyl hydantoin, primadone ---
petitmal epilepsy: ethosuximide. Chlorzepam. Trimethadione, Na valproate
23. Grandmal epilepsy: Na valproate, phenobarbital, diphenyl hydantoin, primadone ---
petitmal epilepsy: ethosuximide, chlorzepam, trimethadion, Na valproate
24. Grandmal epilepsy: generalized tonic clonic seizure
25. For grand mal benzodiazepines (diazepam) to stop seizures then phenytoin DOC to
maintain
26. Electroencephalogram monitor deep in the brain
27. Drug of choice for ttt of status epilepticus is diazepam
28. DOC in ttt of status epilepticus is diazepam or lorazepam
29. DOC for ttt of trigeminal neuralgia (tic douloureux) is: carbamazepine.
30. Dilantin+phenobarbitone= drop in dilantin level
31. Cholrpromazine side effect is photosensitivity
32. Carpamazepine dose not cause vomiting
33. Carbamazepine self-induces its own metabolism on long-term use
34. Carbamazepine is used for the ttt of trigeminal neuralgia
35. Carbamazepine is the drug of choice for the ttt of trigeminal neuralgia
36. (cont. trigeminal neuralgia) other drugs that have been effective are vit B12 in massive
doses (1mg), and injection of alcohol into the ganglion or the branches of the trigeminal
nerve
37. (cont. trigeminal neuralgia) carbamazepine is remarkably effective in both relieving and
preventing the pain of trigeminal neuralgia. Anticonvulsants such as phenytoin can be
beneficial in some cases.
38. Phenytoin loading dose
39. Anti convulsant drug is category D pregnancy? Valporic a- barbeturate- carpamazipine-
BZD
40. Use of ethosuximide: absence seizures
41. Loading dose of phenytoin in status epilepticus: 15-20mg/kg/day
42. Loading dose of phenytoin in epilepsy: 4-5mg/kg/day.
43. Triggers for seizures except which one? I think loud noise
44. Neural tube defects (spina bifida) : valproic acid-phenytoin-carbamazepine
45. Loading dose of phenytoin in Status epileptics: 15mg - 20 mg /kg
46. Drug causing hyperglycemia.. clonazepam
47. Use of ethosuximide: absence seizures
48. Phenytoin Loading Dose
49. Loading dose of phenytoin in status epilepticus: 15-20mg/kg/day
50. Loading dose of phenytoin in epilepsy: 4-5mg/kg/day.
51. In Epilepsy, what is the mechanism?.....Ans. Decrease in GABA so we use all the drugs
which increases GABA
52. Hyponatremia.........is side effect of Carbamazepine.
53. Epileptic in preg
54. Drug not used in gen seizure: ethosuxamide, phenytoin, carbamazeptin, lamotrig
55. Anti convulsant drug is category D pregnancy? Valporic a- barbeturate- carpamazipine-
BZD
56. Which decreases seizure threshold … options all antiepiletics and ciproflox

Eye recalls

1. Pt taking phospholine iodide should not take succinylcholine


2. Dipivefrin is used in glucoma
3. Antocholiesterases (parasympathomimetics) act in glaucoma by dec IOP, inc drainage of
aquous humor
4. Sulfacetamide eye drop is not destryed by heat in the autoclave
5. Preservatives in eye drops as bacteriocidal: e.g. benzalkonium chloride 0.02%,
chlorohexidine 0.01
6. Phospholine iodine is stored at 2-8 DC
7. Phospholine iodide is stored at 2-8 C
8. Phenyl mercuric nitrate 0.002% is eye drop preservative
9. Pheny Hg nitrate 0.002% is eye drop preservative bacteriostatic
10. Loteprednol : ttt of allergic conjunctivitis
11. Latanoprost: for open angle glaucomaif the phenytoin dose in inadequate (fit occur)
what is the dose increment? 30 mg/day
12. "Drugs used for open angle glaucoma: carbachol, demecarium, physostigmine,
13. neostigmine, pilocarpine, timolol maleate, epinephrine BUT NOT cyclopentolate
(cyclogyl)"
14. Drugs causing occular problems: amiodarone, ethambutole, chloroquine, digoxin
15. Cycloplegic for kids atropine drops
16. Cortisone eye drops should be stored at 2-8 DC
17. Cortisone eye drop should be stored between 2-8 C
18. Chlorhexidine in eyedrop: 0.2%
19. Atropine is C.I in narrow angle glaucoma
20. Advantages of timolol over pilocarpine is: longer duration of activity, no effect on visual
acuity or accommodation, little or no effect on pupil size
21. Adrenaline drops has SHORT ACTING mydriatic effect NOT homatropine
22. Betaxolol decrease aqueous humor production
23. Shelf life of opened Eye drops? → 28days
24. Tropicamide cause mydriasis for 3-4 hrs
25. Timolol dec aqueous humor formation thus dec IOP BUT has NO effect on pupil size or
aqueous humor outflow
26. Refrigirate phospholine iodine ( 2 - 8 )
27. Physostigmine: short acting anticholinesterase used in the ttt of primary open angle
glaucoma and for emergency ttt of angle-closure glaucoma -- neostigmine is similar in
action to physostigmine
28. Parasympathomimetics: ttt of glaucoma
29. Ocusert pilo-20: pilocarpine 20mcg/hr -- ocusert pilo-40: 40mcg/hr -- each enough for 1
week
30. Narrow angle glucoma attacks ttt by parasympathomimetics
31. Narrow angle glaucoma is present in about 10% of total glaucoma population
32. Narrow angle glaucoma is present in 10% of total glaucoma population
33. Narrow angle glaucoma is C.I with atrpine or other anticholinergics
34. Miotic effect of pilocaropine starts in 15-30 minutes -- max reduction in IOP in 2-4 hrs --
duration: 4-8 hrs
35. Homatropine is C.I. with glaucoma
36. Epinephrine: ttt of chronic open angle glaucoma BUT C.I. in narrow angle glaucoma due
its mydriatic action which may precipitate acute angle glaucoma
37. Dipivefrin is prodrug of epinephrine, eye drop in glucoma
38. Dipivefrin is a prodrug of adrenalin
39. Dipivefrin HCl is prodrug of adrenaline used in ttt of glaucoma
40. Cyclopentolate 1%, tropicamide 3hrs duration shorter than atropine (2 weeks)
41. Cyclopentolate (cyclogyl) is a mydriatic and cycloplegic used for refraction work and
ophthalmoscopy
42. Carbachol is used as a replacement when resistence or intolerence to pilocarpine occurs
43. Preservatives in eye (bactericidal) benzalkonium Cl 0.02%, chlorohexidine acetate
0.01%- it is sterilized by autoclav or heating with bactericidal at 100 DC for 30 min or
filteration
44. Percentage of chlorbutol used as preservative in eye drops is 0.5%
45. Chlorambutol 0.5 % is used as preservation in eye drops
46. Timolol is used for ttt og glucoma as it dec the production of aqueous humor
47. Guanthidine eye drops 5% used 1-2 times in eye lid edema
48. B-blockers: used in glaucoma: timolol, levobunolol, carteolol, metapranolol, betaxolol
49. Pilocarpine in open angle glaucoma cause constriction of the pupil and produce
dimming vision of night
50. Cortisone eye drop should be stored from 2-8 C
51. Chlorbutol (preservative in eye drops)= 0.5%
52. Adrenalin 1% eye drop produce 1-2 hr duration
53. Acetazolamide, timolol: dec aqueous humor formation
54. 1% adrenaline gives short rapid mydriasis but chronically dec IOP by inc aqueous humor
outflow
55. 1% adrenaline = short rapid mydriasis
56. Belladonna is not recommended in glaucoma because it containes atropine
57. Atropine C.I. with glucoma
58. Preservatives in eye drops : cholrocresol 0.1 % , benzalkonium Cl 0.02% ,chlorohexidine
0.01 % , Na edetate 0.1 % , phenyl Hg nitrate 0.002 % , cetrimide 0.005 % ,chlorambutol
0.5 % - % of chlorocresol 0.05% -1 % (0.1%) -

Gout recalls

1. Facts and Comparisons: names of several vitamin tablets containing flouride - relative
cost of several commercial antacid liquids --- Facts and Comparisons lists prescription
and some nonprescription drug products by pharmacological classification
2. (cont. Facts and Comparisons) those prescription only vitamins that contain fluoride are
listed together so that the pharmacist can compare formulas and levels of ingredients.
Facts and Comparisons features a cost index, which indicates the relative cost
3. (cont. Facts and Comparisons) of similar products based upon cost per ml, per tablet, or
other common dosage base
4. Klinefelter's syndrome is a series of symptoms related to diminished development of the
seminiferous tubules of the testes
5. If both parents have recessive genes it is enough to produce disease in children even if
the parents have no disease
6. Uricosuric agents increase excretion of uric acid like probenecic, sulphipyrazone BUT
NOT allopurinol
7. Uric acid is a derivative of purine
8. Tophus is gout
9. Tophi is characteristic of gout
10. Pt suffering from gout and taking probenecid should be warned not to take aspirin
11. Pt on probenecid therapy should NOT take aspirin or indomethacin or thiazide
12. Probenicid is uricosuric
13. Probenecid is contraindicated with aspirin
14. Probenecid # excretion of: sulfonamides, sulfonylureas, indomethacin, naproxen,
clofibrate, ASA, pantothenic acid, penicillins
15. Phenylbutazone is used for gout 7%
16. Patient taking aspirin should avoid probenecid
17. Not taken with tea = allopurinol
18. "Gout ttt: acute=cholchicine/chronic=allopurinol/ aspirin and corticosteroids and
19. phenylbutazone are also used"
20. Gout occurs more in men than in women
21. Drug used in the ttt of gout and does not affect urate metabolism or secretion:
colchicine. NOT: allopurinol, probenecid, sulfinpyrazone. Colchicin used in ttt of acute
attacks of gout, it interfers with inflammatory response to gout
22. Azathiprine or 6-mercapto purine + allopurinol = inc levels of both drugs BUT 6-
thioguanine is not affected bu allopurinol because it's metabolized by methylation not
oxidation
23. Azathioprine + allopurinol:: increased levels of both drugs -- 6-MP + allopurinol::
increased levels of both drugs
24. Aspirin is C.I. with probenecid
25. Allopurinol: has no effect on warfain plasma protein binding, can be given safely with
warfarine -- also chlopheniramine can be given safely with warfarin
26. Allopurinol is NOT taken with tea
27. Allopurinol inhibits xanthine oxidase, the enzyme which converts hypoxanthine to
xanthine, and xanthine to uric acid
28. Allopurinol does NOT affect warfarin
29. Allopurinol advice: high fluid intake
30. Allopurinol # xanthine oxidase
31. Allopurinol # metabolism of 6-MP NOT 6-TG
32. 1st choice in acute gout attack is colchicine
33. Hyperuricemia occurs more likely in men
34. Allopurinol mechanism of action
35. Regarding Gout, select wrong option: Gout is more common in women
36. Aspirin is not taken with probenicid - aspirin decreases the uricosuric effect of
probenicid- aspirin toxicity = veritigo , tinitus
37. Aspirin decrease uricosuric effect of probenicid
38. Allopurinol is NOT C.I. with warfarine
39. Acetaminophen decrease uricosuric effect of probenicid

Herbal hemorrhoids recalls

1. GTN tablets shelf life once opened


2. GTN shelf life … 3 months , 6 months , 28 days
3. GTN causes increase in adenyl cyclase
4. Counseling points about hemorrhoids in pregnancy, select the wrong answer: Treat
aggressively during pregnancy otherwise they will relapse after birth?
5. Handbook of Nonprescription drugs:: comparison of sodium content of a group of
antacid liquids - active drug in Sominex tablets -- the chapter that discusses antacids lists
commercial products, with the sodium content of each
6. (cont. Handbook of Nonprescription Drugs) is listed in the section discussing sleep aids
7. (cont. Handbook of Nonprescription Drugs) in the OTC product in considered. Tablets
are present that list commercial products, manufacturers, ingredients, and levels of
ingredients when known. For example the active drug in Sominex tablets
8. (cont. Handbook of Nonprescription Drugs) each chapter of the handbook covers a
specific group of the OTC products. Usually the anatomy and physiology of the body
area affected are discussed. Also the pharmacologic action of ingredients commonly
included
9. Interaction with St John’s Wart
10. Gingko is not/was not used in which disease..a) Chillblains..b) Poor concentration..c)
Abdominal spasms
11. Interaction with St John’s Wort
12. Ginko Biloba is not used for which condition
13. Gingko is not/was not used in which disease a) Chillblains b) Poor concentration c)
Abdominal spasms

Hormones recalls

1. Woman taking combined pills for 21 days but the bleeding does NOT occur, she should
stop the pills as she may be pregnant
2. Tamoxifen is antiestrogen
3. Stein-Leventhal syndrome is a collection of symptoms related to the hypersecretion of
andregens by the ovarian stroma
4. Skin contraceptive implants: levonorgestrel
5. RBCs formation is controlled by erythropoietine
6. Posterior pituitary gland secretes ADH, oxytocin
7. Petrolatum dissolvesrubber in condoms and diaphragms
8. Parathyroid deformation affect absorption of Ca
9. Norethindrone is used in endometriosis but medroxyprogesterone is better
10. Norethindrone is used in endometriosis -- danazole is used in endometriosis
11. Nonoxynol: SAA, spermicidal: contraceptive
12. Nilutamide (antiandrogen): delay dark adaptation
13. Metyrapone is useful as a diagnostic agent for pituitary function
14. Metyrapone is a diagnostic agent for pituitary function. Metyrapone is an inhibitor of
11- hydroxylation in the adrenal cortex. Through this inhibition, metyrapone interfers
with the adrenal syn of cortisol and corticosterone
15. Mestranol is estrogen not progesterone
16. Mestranol is estrogen not progesterone
17. Mestranol is estrogen not progesterone
18. Mestranol is estrogen
19. Mestranol : estrogen
20. Medroxyprogesterone: a progesterone NOT a corticosteroid
21. Long term androgen: hepatic carcinoma, edema, testicular atrophy
22. Long term androgen ttt= hepatic carcinoma, edema, testicular atrophy
23. In-home pregnancy test by Warner Chilcott asseys for the presence of human chorionic
gonadotropine (HCG) -- positive result is indicated by dark donut shaped brownish ring
in the tube
24. Hypoparathyroid ttt: calcitriol, vit D --- hyperparathyroid ttt: calcitonin, vit D analogues
25. FSH, LH reach highest levels during ovulation
26. FSH is controlled by the blood estrogen level
27. FSH inc estrogen ---- LH inc progesterone
28. Estrogen: breakthrough bleeding
29. Estrogen secretion is controlled by FSH
30. Estradiol is secreted from the ovarian follicle
31. Erythropoietin is a glucoprotein secreted by kidney to increase production of RBCs
32. Epotein alpha : inc RBCs
33. Endometriosis: menstrual like bleeding with pain and inflammation, ttt by danazole
(androgen)
34. During ovulation FSH and LH reach highest peak
35. Drugs that may cause diabetes insipidus: Li, amphotricin B, demeclocyclin --- ttt by ADH
36. Desmopressin ( vaspressin ) is ADH used in ttt of diabetes insipides
37. Demeclocyclin in ADH antagonist and so cause diabetes insipidus which is ttt by ADH
38. Demeclocyclin cause D. insipidus and ttt is by ADH
39. Deficiency in posterior pituitary hormones will cause diabetes insipidus
40. Danazole ttt of endometriosis
41. Danazole is used to treat endometriosis
42. Danazole is an androgen that inhibits gonadotropin release and so it's used fot ttt of
endometriosis
43. Cushing's syndrome is a series of clinical symptoms related to the excessive secretion of
cortisol by the drenal cortex
44. Cushing syndrome: Xss secretion of glucocorticoinds, osteoporosis, inc Bl.
Pr.,hyperglycemia
45. Cretinism is due to deficiency in iodine in children
46. Corpus leutum secrets mainly progesterone
47. Corpus leuteum secretes mainly progesterone
48. Congenital adrenal hyperplasia: deficiency of 21-alpha-hydroxylase
49. Combined pills (estrogen, progesterone) inhibit pituitary gonadotropins so inhibit
ovulation
50. Clomiphen is an antiestrogen
51. Clomiphen citrate is used clinically to ttt infertility --- tamoxifen citrate is used primarily
to ttt estrogen-dependet neoplasms
52. Clomid is 50 mg for 5 days
53. chlorpropamide: has an antidiuretic effect which may be clinically useful in diabetes
insipidus, may require several weeks to be eliminated from the body after it is
discontinued
54. Chlorpropamide is not uricosuric, has antidiuretic effect so used in diabetes insipidus,
take several weeks of elimination after stopping of medication, DOC for D. insipidus is
vasopressin
55. Cause of addison's disease: dec in ACTH secretion… ttt by mineralocorticoids,
glucocorticoids
56. B-estradiol has steroid structure
57. Antiandrogens: finasteride, nilutamide (delay dark adaptation)
58. ADH inc tubular permeability thus inc water reabsorption
59. Addison's disease is hypofunction of the adrenal cortex BUT cushing syndrome is
hyperfunction of the adrenal cortex
60. Addison's disease is due to the hypofunction of the adrenal glands. It is characterised by
a bronze pigmenation of the skin, progressive anemia, low blood pressure, diarrhea and
severe prostration
61. Acromegaly is a disease caused by the presence of a pituitary tumor which results in the
production of xss growth hormone
62. (cont. metyrapone) this in turn leads to the secretion of of the precursor 11-
deoxycortisol. In the presence of normal pituitary function, there's a compensatory inc
in ACTH production. This stimulates the adrenal cortex,
63. (cont. metyrapone) but because of the inhibition 11-hydroxylation, cortisol production
remains low and 11-deoxycortisol is produced in greater quantities. This response is a
measure of the capacity of the anterior pituitary to produce ACTH
64. Which is not alike:noregestrel, mestronol, progestin, cyproteron
65. Tamoxifen side effect is hot flushes
66. Raloxifene acts on estrogen in bones and lipids
67. Deficiency in iodine in food leads to cretinism in children
68. Combined estrogens CI in breast feeding
69. Dose regimen of progesterone in hormone replacement therapy?
70. Patient with polydipsia and polyuria, which is wrong:-vasopressin is high
71. Progesterone doses were given for contraception, endometriosis, HRT: select the wrong
answer from 4 doses
72. OC mechanism: inhibits follicular development and ovulation
73. FSH levels depend on oestrogen
74. Medroxyprogesterone question
75. Pth - calcium – vitamin d question?
76. LH sec is regulated by which one: est level in blood, adrenal, menstrual cycle…
77. Hypothyroidism.....wht are the symptoms?....Ans. Myxoedema
78. Dose regimen of progesterone in hormone replacement therapy
79. Addison’s disease.............its a disease of adrenal cortex.
80. Warner Lambent test : test for human gonadotropins --- metyrapon: diagnostic for
pituitary function
81. Menotropin is used for infertility
82. Erythromycin estolate is better when taken orally
83. Pamaprom (diuretic) is effective in ttt of PMS, it is derived from theophylline

HTN recalls

1. What is the most cause of HTN: unknown mechanisms


2. Verapamil: has the most Ca channel blocking activity
3. Verapamil is C.I. with: digoxin, Ca, disopyramide (48 hr spacing)
4. Triamterin: K sparing diuretic
5. Triamterene is a K-sparing diuretic
6. Toxicity of thiazides is due to decreased blood volume
7. Toxicity of thiazide is due to decreased blood volume
8. Thiazides dec HTN by dec blood volume
9. Thiazides dec glucose tolerance
10. Thiazides cause hypokalemia
11. Thiazides can be related to hyperuricemia
12. Thiazide SE is gout induction
13. Thiazide diuretics dec excretion of uric acid
14. Thiazide diuretics cause hyperglycemia, dec glucose tolerance
15. Thiazide diuretics : dec (Na, Cl, K, Mg), inc (Ca) and alkalosis -- loop diuretic: dec (Na,Cl,
K, Mg, Ca) and alkalosis -- K-sparing: dec (Na), inc (K, Cl) and acidosis
16. Thiazide dec glucose tolerance leading to hyperglycemia
17. Thiazide cause hypokalemia and hypochloremia and systemic alkalosis
18. Thiazide cause hypercalcemia(so good in osteoporosis on chronic use in elderly pts)
hyperlipidemia
19. Thiazide antagonizes insulin
20. Thiazide antagonize insulin
21. Thiazide + methyldopa = to relieve salt and water retention
22. The MOA of amiloride is most similar to triamterene, NOT TO: spironolactone, HCTZ,
metolazone, chlorthalidone. Amiodarone and triamterene are K-sparing diuretics that
exert diuretic effect by promoting exchage of Na for K in the distal tubules
23. The main sourse of peripheral resistance=arterioles
24. The ganglionic blockers are not as other antihypersensives because they do not
selectively block sempathetic ganglia but they also block parasympatheic ganglia causing
unpleasant anticholinergic side effects
25. The antihypertensive effect of guanethidine is inhibited by amitriptyline
26. TCA, corticosteroids may cause HTN
27. Starting HCTZ dose in mild HTN: 50mg
28. Spironolactone is anti-aldosterone
29. Site of action of spironolactone: DCT (distal convoluted tubules)
30. Sensitization to the sunlight may be produced in a pt being ttt with bendrofluazide
31. Selective B1 blockers: atenolol, metoprolol, bisoprolol
32. Selective B1 antagonists (cardioselective) : atenolol, metoprolol, bisoprolol
33. SE of thiazide is hyperglycemia
34. SE of spironolactone: hyperkalemia, gynecomastia, postmenoposal bleeding
35. SE of Ca channel blocker is constipation and edema
36. SE of B-blockers: cold extremities, bronchospasm, inc hypoglycemic effect of insulin, dec
HDL, up-regulation of receptors on long use, nightmares
37. SE of amlodipine: peripheral edema, pruritis
38. SE of ACEIs: angioedema ( swollen lips)
39. SE of ACEIs: 1st dose hypotension and syncope, agranulocytosis, chronic dry cough,
hyperkalemia, cholestatic jaundice -- C.I. of ACEIs: renal artery stenosis, pregnancy
40. SE of ACEIs is dry cough
41. Safe diuretic with sulfonamide sensitivity: ethacrynic acid, spironolactone
42. Safe diuretic with sulfonamide sensitivity is spironolactone, ethacrynic acid
43. Raynaud's disease: pallor or cyanosis of the fingersor toes
44. Pts arrived in hospital with hypertensive crisis will be ttt with diazoxide
45. Pt taking pargyline and have common cold should not take phenylephrine HCl
46. Pt on propranolol having cold extremities, nightmares should shif to atenolol
47. Pt on indapamide should take K supplement
48. Propranolol shows first pass metabolism that when given orally it has little systemic
effect
49. Propranolol is used with hydralazine to control tachycardia caused by hydralazine
50. Propranolol is used with hydralazine to control reflex tachycardia caused by hydralazine
51. Propranolol is used with hydralazine to control reflex tachycardia caused by hydralazine
52. Propranolol is not recommended with verapamil
53. Propranolol incsease hypoglycemic action of insulin also masks the signs of
hypoglycemia
54. Propranolol does not cause tremors or tachycardia -- B-agonists cause tremors
55. Prolonged use of spironolactone causes gynecomastia
56. Primary site of action of K-sparing diuretics is distal tubules
57. Prazocisn causes 1st dose effect: marked hypotenstion with syncope
58. Prazocine SE: 1st dose syncope/ hypotension/ phenomenon
59. Prazocin is not used as initial antihypertensive ttt
60. Pindolol: non selective B blocker with intrinsic sympathomimetic activity-- minoxidil:
vasodilator -- enalapril:ACEI -- guanabenz: centrally acting alpha2 agonist
61. Pindolol is the only B blocker with sympathomimetic activity --- carteolol, pinbutolol
62. Perindopril 24mg: dose not appropriate to adults
63. Patients on propranolol and metoprolol having nightmares may shift to more
hydrophyllic B-blocker like atenolol or nadolol
64. Pargyline is antihypertensive agent should not taken with food containing tyramine
65. Overdose of Na.nitroprusside= CN poisoning
66. Nylidrin (Buphenine) is useful as a vasodilator, the vasodilator activity of nylidrin
appears to be a combination of direct musculotropic and B-agonistic activity. It has been
used in a variety of vascular disorders without proof of efficacy
67. NTG dec preload --- hydralazine dec afterload
68. Nitroglycerine mainly dec preload
69. Nitroglycerine inc venous pool of blood
70. Nitroglycerine dec preload while hydralazine dec afterload
71. Niphedipine is short acting dihydropyridine Ca channel blocker
72. Na.nitroprusside: CN toxicity, protect from light, slow IV infusion
73. Na prusside is arterular and venular dilator , give by slow IV infusion
74. Minoxidil is assoc with reflex tachycardia, as hydralazine
75. Metoprolol is B1 antagonist
76. Metoprolol is a selective B-blocker -- but it is like propranolol in the way it crosses the
BBB and may cause nightmares, in this case shift to a more hydrophilic selective B-
blocker like atenolol
77. Metolazone is similar to chlorthalidone
78. Methyldopa interactions: inc the effect of all antihypertensive agents
79. MAOIs are C.I. with guanthidine
80. Mannitol: ttt of cerebral edema (hexahydric alcohol)
81. Manitol IV hypertonic 10-25% soln: osmotic diuretic used in: prophylaxis of acute renal
failure, diagnosis of acute oliguria, dec pressure and vol of intraocular and cerebrospinal
fluids
82. Main source of blood flow resistence is arterioles
83. Loop/ thiazide diuretics are contraindicated with gout
84. Loop diuretics: furosimide, bumetanide, ethacrynic acid act by in Na secretion
85. Loop diuretics: furosemide, bumetanide, ethacrynic acid
86. Loop diuretics inc renal PGs
87. Loop diuretics cause dose related ototoxicity, alkalosis, hypokalemia
88. Loop diuretic SE: dose related ototoxicity, alkalosis, hypokalemia
89. Loop diuretic inc the prostaglandind
90. Lipid solubility order of B-blockers: atenolol, metoprolol, propranolol
91. Labetalol used in HTN because it blocks alpha and B receptors:: labetalol dec blood
pressure by blocking alpha adrenoreceptors in peripheral arterioles and thereby
reducing peripheral resistance. Also concurrently blocks B-adrenoreceptors,
92. Initial drug therapy of most HTN pts: thiazide diuretics
93. Indomethacin dec antihypertensive effect og B-blockers
94. Indapamide: thiazide diuretic
95. Indapamide pt councelling is: take K supplement as orange juice
96. Indapamide may cause K loss so pt requires K supplement
97. Indapamide is contraindicated in pts taking alcohol ??
98. Indapamide is C.I with alcohol
99. In HTN we don't use atropine because it dec heart rate
100. In HTN we do NOT use atropine
101. In contrast to spironolactone neither amiloride nor amiodarone inhibit
aldosterone.. Metolazone, HCTZ, chlorthalidone are thiazide diuretics
102. If pt on captopril or enalapril is suffering from dry cough: this is because of the
drug (ACEIs) -- if the pt above is suffering now from productive cough then the ttt should
be: guifensin NOT (dextromethorphan and paracetamol)
103. If a pt taking metoprolol but cannot sleep your advice is: shift to atenolol, take
diazepam
104. Hypertensive pts should not use carbinoxolone
105. Hypertensive pts should not use carbenoxolone ( licorice plant)
106. Hypertensive crisis caused by tyramine +MAOIs is treated with an alpha blocker
like phentolamine or phenoxybenzamine
107. Hypertension in pregnancy it ttt by methyldopa
108. Hydrophylic B-blockers: atenolol, nadolol, esmolol -- lipophylic B-blockers:
propranolol, metoprolol, timolol, betaxolol
109. Hydralazine SE is a syndrome resembling SLE
110. Hydralazine cause anginal attack due to coronary steal phenomenon
111. Hydralazine (antihypertensive, vasodilator) may cause ANGINAL ATTACK due to
CORONARY STEAL PHENOMENON
112. Hydalazine is antihypertensive of choice in pts with renal insufficiency
113. HTN pt taking amitriptylene develops depression due to its anticholinergic
effects should shift to trazodone (only inhibits reuptake of serotonin not NE)
114. HCTZ+propranolol = dec edema
115. HCTZ is taken in the morning with food or milk
116. HCTZ interacts with digoxin and lithium --- HCTZ inc Na excretion so leads to Li
toxicity --- HCTZ inc K excretion so leads to digoxin toxicity
117. HCTZ and hydralazine: most probably antihypertensive of choice in pt with
severe depression
118. HCTZ + propranolol = dec edema
119. Haloperidol is C.I with guanthidine and alpha methyldopa
120. Guanthedine, methyldopa, clonidine cause bradycardia but hydralazine cause
reflex tachycardia
121. Guanthedine interact with TCAs
122. Guanithidine, methyldopa, clonidine all cause bradycardia BUT hydralazine
causes reflex tachycardia so we use B-blocker with it, it also causes SLE (systemic lupus
erythematosus) and coronary steal phenomenon causing angina
123. Guanethidine: parasymp. Tone predominate : diarrhea
124. Guanethidine makes parasympathetic tone predominate thus causes diarrhea
125. Guanabenz is alpha 2 agonist used in the ttt of HTN
126. Glyceryl trinitrate ( nitroglycerine ) is venules dilator - Na nitroprusside is
arterular and venular dilator - arterular dilators : daizoxide , minoxidil , hydralazine .
127. Gentamicin enhances nephrotoxicity of ethacrynic acid
128. Fenoldopam ( D1 agonist) : ttt of HTN
129. Ethacrynic acis is used in pts with sulfa allergy
130. Ethacrynic acid is C.I with gentamicin (additive ototoxicity)
131. Erectile dysfunction may be drug indused or HTN ttt SE
132. Duration of thiazide diuretics: HCTZ: t1/2= 15hrs --- chlorothiazide t1/2 =3hrs ---
chlorothalidone t1/2=50hrs
133. Drugs that cause iatrogenic HTN: TCA, O.C., clonidine withdrawal, corticisteroids
134. Drugs that canNOT be given IV bolus:: prazocin, nitroprusside, KCl
135. Dose of HCTZ: 0.5-1g
136. Dose of chlorothiazide is 500 - 2000 mg / day
137. Don't take NaHCO3 (antacid) in HTN
138. Diazoxide is administered by rapid IV injection
139. Coon's : inc of hyperaldosteronemia
140. Codeine, indomethacin = should not be taken in HTN dye to salt and water
retention
141. Clonidine is prophylactic in migraine ttt
142. Chlorthalidone: 12.5-50mg with the longest activity, t1/2=40-65hrs
143. Cells of distal convoluted tubules are sensitive to aldosterone
144. Captopril SE: renal insufficiency, irritant dry cough
145. Captopril is ACEI
146. Captopril causes hyperkalemia so it is C.I. with K sparing diuretics
147. Bumetanide SE is myalgia
148. Bradykinins increase vascular permeability to release PGI2 to relax smooth
muscles
149. Bradykinins increase vascular permeability to release PG12 to relax smooth
muscles
150. Bradykinine cause potent vasodilation
151. Bradykinin are peptides: arterial vasodilators, constrict brochi and intestines,
cause pain and inflammation and allergy
152. Bendrofluazide SE: photosensitivity
153. Bendrofluazide is a thiazides
154. B-blockers are C.I. with verapamil
155. B-blocker and diuretics cause dyslipidemia
156. B-blocker + verapamil = severe bradycardia
157. B bloclers are C.I. with verapamil
158. Atenolol is the least lipid soluble B blocker
159. Arterial HTN needs immediate medical attention (responsible for angina)
160. Antihypertensive that causes angina is: hydralazine (the steal phenomenon)
161. Antihypertensive NOT C.I. with amitriptyline: HCTZ ??? -- chlorothiazide is
contraindicated with amitriptyline
162. Antihypertensive effect of alpha methyl dopa is due to its central alpha agonistic
effect, where it's metabolized to alpah methyl norepinephrine (active)
163. Amlodipine : least reflex tachycardia
164. Alpha methyl dopa antagonize TCA
165. Alpha 2 agonists, reserpine, guanethidine :: cause depression
166. All ACEIs are prodrugs except captopril and prinivil (lisinopril)
167. Aldosterone is a mineralocorticoid
168. Aldosterone hormone is a mineralo corticoid acts on renal tubules causing salt
and water retention
169. Aldosterone = control electrolytes
170. Aldosterone + spironolactone = hyperkalenia
171. Adverse effect of verapamil..constipation
172. Actazolamide increase K secretion , diuretic , carbonic anhydrase inhibitor ,
cause systemic acidosis and urine alkalosis , ttt of systemic alkalosis
173. Acetazolamide is rarely used because of systemic acidosis and urine
alkalinization
174. Acetazolamide is carbonic anhydrase inhibitor
175. Acetazolamide increase K excretion
176. Acetazolamide causes urine alkalinization
177. Acetazolamide causes urine alkalinization
178. Acetazolamide causes systemic acidosis and urinary alkalosis
179. Acetazolamide causes hyperchloremic acidosis and urinary alkalosis
180. Acetazolamide caused metabolic acidosis and urinary alkalosis
181. ACEIs may cause severe hypotension
182. ACEIs cause hyperkalemia so C.I. with spironolactone.. And can be taken with
thiazide diuretics
183. ACEIs are C.I. is asthma, renal artery stenosis
184. 1st choice for ttt of emergency hypotensive shock is dopamine
185. (continue labetalol MOA) notably in the heart, from the reflexly mediated drive
caused by peripheral vasodilatation. Therefore, the reduction in blood pressure is
achieved without cardiac stimulation
186. Spironolactone is K sparing diuretic
187. Methyl dopa side effect is severe hypotension
188. Irbesartan mech of action
189. Carbonic anhydrase inhibitors cause metabolic acidosis
190. ACE inhibitors SE is hyperkalemia and increased creatinine
191. Ace inhibitors mode of action
192. Where is the pulse taken most commonly?a) Radial artery...b) femoral artery
193. Propanolol should be avoided with asthma patients
194. Captopril side effect: cough
195. Thiazide diuretics MOA: increase excretion of sodium and water
196. Spironolactone: Aldosterone Antagonist
197. Question on Betaxolol use, avoid in CHF?
198. Question about sartans, select wrong answer, decrease potassium levels and
creatinine
199. Ca channel blockers do not cause bronchospasm
200. ACE inhibitors select wrong answer, increases aldosterone
201. Where is the pulse taken most commonly? a) Radial artery b) femoral artery
202. Patient is on Propranolol, having CNS side effects of Beta-blockers. What can be
done? Ans: Selection of Atenolol because it doesn’t have lipid solubility so can’t cross
Blood Brain Barrier.
203. Lisinopril maximum dose in mild heart failure: (2.5mg– 10mg – 20mg – 60mg)
204. Drug of Choice for diabetes. Ans. ACE/SARTANS
205. Captopril side effect: cough
206. ACE Inhibitors side effects.
207. ACE inhibitor..........mech of action
208. NaHCO3 is contraindicated with HTN
209. Don't take NaHCO3 with HTN??
210. Patient with chesty cough, history of hypertension and high cholesterol:
Guaiphenesin with honey and glycerol
211. Drug used in HTN and diabetes
212. Drug used in HTN and Angina
213. Metoprolol is similar to propranolol in pharmacological effect
214. Haloperidol + alphamethyldopa = life-threatening reaction

Hyperlipidemia recalls

1. Carbacol=cholinergic drug -- probucol=antihyperlipidemic


2. Niacin=# lipolysis
3. Most common side effect of statins in hepatotoxicity
4. HDL: scavenger of cholesterol protecting arteries
5. Dose limiting SE of nicotinic acid: flushing of skin (itching) due to inc PG so give it with
aspirin
6. Cholestyramine interfers with GIT absorption of : chlorothiazide, warfarin, digoxin, TC,
phenylbutazone, phenobarbital
7. Atherosclerosis: inc in LDL
8. Drug interaction of Warfarin + Simvastatin

Immunology recalls

1. TXA2 cause platelet agregation


2. T-cells, B-cells : 1ry response # antigen
3. T-cells mature in thymus gland
4. Specific allergic reaction is by IgE NOT IgG, IgM, IgA, IgD -- IgG is major in serum plasma,
pass placenta --IgM: 1ry produced due to antigen -- IgA: in body secretions -- IgD: 1%
antigen receptor??
5. Lymph glands filter out solids by phagocytosis
6. Immunoassay is used for all (antidody, enzyme, drug level, receptor distribution)EXCEPT
electrolytes
7. Immunity is related to thymus gland
8. IgG: major in serum, plasma, ONLY pass placenta -- IgM: 1st produced in response to
antigen -- IgA: major in body secretions -- IgE: allergy spicific -- IgD: (1%) antigen
receptor
9. If a pt has hypersensitivity the the diagnostic lab test can be done is complete blood
picture and differential WBCs
10. Hypersensitivity::: I: IgE -- II: IgM, IgG : organ specific -- III: non organ specific -- IV: T-cells
11. Function of lymph glands: filter out solids by phagocytosis
12. Filgrastim is a human granulocyte colony stimulating factor
13. Eosinophils inc in: parasitic infections, allergic conditions -- neutrophils inc in: most
bacterial infections -- basophils may be increased in certain blood dyscrasias --
monocytes: aften greatly increased in chronic infections such as TB
14. Anaphylactic reaction occurs after second exposure to the antigen
15. Anaphylactic reaction occurs after second exposure to antigen
16. Immunoassays do not measure? Electrolytes
17. Hypersensitivity reactions are caused by IGE
18. Drug related anaphylaxis (anaphylctic shick) occurs within few minutes of drug
administration
19. Anaphylaxis treatment: epinephrine
20. Sargamostin: myeloid reconstitution after BM transplantaion
21. IgG: major in serum, plasm, only one pass placenta --- IgM: first produced in response to
antigen --- IgA: major in body secretions --- IgE: allergy specific --- IgD:(1%) (antigen
receptor)a

Lab tests recalls

1. Sulfobromophthaline: test for liver function


2. Mantoux test is with tuberculin PPD NOT diphtheria antitoxin
3. Lab tests and organs:: creatinine clearance: kidney -- bilirubin: liver -- protein bound
iodine PBI: thyroid -- amylase: pancreas -- alkaline phosphate: liver -- blood urea
nitrogen BUN: kidney -- lactic dehydrogenase: heart -- thymol turbidity: liver
4. Diagnistic agents:: azoresin: detection of achlorhydria -- congo red: detection of
amyloidosis -- Evans blue: determination of blood volume -- phenolsulfonphthaline:
determination of kidney function
5. (sulfobromophthaline: test for kidney function) the dye soln is injected IV & a blood
sample is withdrawn after 30 minutes for comparison with a standard. A normally
functioning liver will excrete most of the dye within that 30-min period
6. (phenolsulfonphthaline (phenol red): determination of kidney function) it is injeected
either IM or IV. Approximately 80% of the dye is excreted within 2hrs. Deficient kidney
function causes either delayed or incomplete elimination of the dye.
7. (Evans blue: determination of blood volume) after IV injection Evans blue binds to
plasma proteins. A blood sample is withdrawn and asseyed to estimate total blood
volume
8. (cont. azoresin) the dye is the absorbed and excreted in urine within two hours. The
concn of the excreted dye can be estimated by comparison of a color chart
9. (congo red: detection of amyloidosis) congo red is injected into the blood. Diappearance
of the dye from the blood indicated retention by abnormal amyloid deposits
10. (azoresin: detection of achlorhydria): a gastric secretion stimulant is given 1hr before
the administration of azoresin. If gastric secretion is normal, HCl will displace the dye
from the resin portion of the azoresin.
11. Isoenzyme assay is indicative of tissue necrosis
12. One case study and the question was about when should the Na solution to be taken for
gastric emptying?.......Ans. One day before colonoscopy

Liver recalls

1. Phenobarbital is used to treat drug-induced neonatal jaundice


2. Liver cirrhosis is progressive fibrosis, scarring of liver
3. Liver cirrhosis is progressive fibrosis, scarring of liver
4. Drug induced neonatal jaundice is ttt with phenobarbital
5. Cholestatic jaundice: erythromycin estolate, ACEIs, (amoxicillin + clavulenic acid),
phenothiazines
6. Cholestatic jaundice is a SE of: erythromycin estolate, chlorpromazine, chlorpropamide,
TCA, trazodone, sulindac, methyldopa
7. Chenodiol is used in dissolving cholesterol gallstones, hepatotoxicity is the most serious
SE, diarrhea is the most common SE
8. Chenodiol dissolves cholesterol gall stones
9. Bile conjugation occurs in liver
10. Bile acids act by fat emulsification
11. Alkaline phosphate level is raised in liver damage
12. Alkaline phosphate level increase in liver diseases
13. Alkaline phospahate inc in liver disease
14. Alkaline phosphate is indicator of liver diseases
15. Which one doesn’t cause liver damage. Eg. Alcohol, PCT.

Metabolism recalls

1. When drug has first pass effect at in the liver that means: it has less systemic effect
2. Waste product of protein is urea
3. Temazepam (BDZ) common metabolism is glucuronidation and alpha-N- delakylation
4. Structure of benzaldhyde is metabolized by oxidation
5. Some drugs show interference between magnitude of activity and plasma concn
because they are quickly metabolized
6. Salicylic acid is conjugated with glycine or glucuronic acid
7. Phenol salts are conjugates or methylates - conjugated with glucuronic acid
8. Phenol is metabolized by glucuronidation and its activity is increased by increased
temperature
9. Phenol is metabolized as phenyl glucuronide
10. P450 inhibitors: cimetidine, erythromycin, fluvoxamine, fluconazole, ketoconazole,
omeprazole, ciprofloxacine, fluoxetine, fluvastatin, nefazodone, verapamil, quinidine
11. P450 inducers: phenobarbital, rifampin, alcohol, troglitazone, phenytoin,
carbamazepine, prednisone
12. Metabolized by acetylation: sulfonamides, INH, procainamide
13. Metabolized by acetylation: INH, hydralazine, sulfonamide, procainamide
14. Metabolism of procainamide= N-acetyl procaineamide
15. Metabolism of drugs results in more polar compounds
16. Metabolism of a drug results in a more polar compound
17. Lofenalac: is a dietary product used in pts sufferring from phenyketonuria (PKU). PKU is
an inherited disorder characterized by high plasma level of phenylalanine hydroxylase
which converts phenylalanine to tyrosine.
18. Favism is due to G-6-PD deficiency
19. Enzyme induction is done by inc rate of enzyme synthesis and dec rate of enzyme
destruction and degradation
20. End result of protein is uric acid
21. (cont. PKU) since aspartam (methyl N-1-alpha-aspartyl-L-phenylalanine) is metabolized
to phenylalanine and aspartic acid and methanol
22. (cont. PKU) routine testing of newborns for PKU is common in the US, ttt is consisting of
the following low-phenylalanine diet that is started early in life. Lofenalac is a complete
food except for its low phenylalanine content
23. (cont. PKU) it's used in place of usual milk in the diet of children with PKU. Untreated
PKU results in mental retardation. Food, beverages containing aspartame (Nutrasweet)
must bear label warning for people with PKU,
24. Metabolism leads to more polar compounds
25. Intraarterial drugs not metabolized by lungs
26. Phase II metabolism produces which metabolites?
27. Drugs that undergo both Phase I and Phase II reactions?
28. Which is not a drug metabolism pathway: oxid, hydrolysis, transamination,
esterification, reduction
29. What CYP for metabl of celecoxib and NSAID
30. What CYP for metab of amiodarone, verapamil
31. Waste product of protein is urea
32. Metabolism of procainamide: N-acetyl procainamide
33. Sulfonamides are metabolized by acetylation
34. Penicillin metabolism= break B-lactam ring giving penicillamine

Narcotics and muscles recalls

1. MOA::: benztropin: anticholinergic -- verapamil: antiarrythmic -- asparaginase:


antineoplastic -- sulphinpyrazone: uricosuric -- tolnaftate: antifungal -- flurazepam:
hypnotic -- acetohexamide: hypoglycemic
2. Tizanidine: ttt of spasticity
3. SE of cyclobenzaprine would be expected to be most similar to the SE of amitriptyline.
Cyclobenzaprine is an analog of amitriptyline, available for the ttt of acute voluntary
muscle spasm
4. Muscle fatigue is due to lactic acid accumulation
5. Exertion of muscle (muscle fatigue) is due to lactic acid accumulation
6. (cont. cyclobenzaprine) because they are so chemically alike in chemical structure,
cyclobenzaprine & amitriptyline have essentially the same SE and toxicity.
7. Vit B6 is used in alcohol toxicity as it decreases alcohol levels
8. ttt of opiate withdrawal: methadone??
9. ttt of constipation due to codeine is by stimulant laxative NOT enema or bulk
10. ttt of alcohol withdrawal syndrome: chlordiazepoxide, chlorazepate, diazepam,
oxazepam
11. Thiazide diuretics enhance the action of amphetamine
12. Theophylline t1/2 dec in smokers
13. Theophylline is not used as antiarrythmic
14. Smocking inc metabolism of theophylline
15. Side effects of codeine: nausea, vomiting, constipation, repiratory depression
16. Respiratory depression cause death in cocaine poisoning
17. Pt with allergy to morphine should not take codeine
18. Pt suffering from acute alcohol withdrawal is given 100mg of chlordiazepoxide IM every
30min give two frequent doses then several hours later the pt will become primarily
atoxic and stuperous due to delayed absorption of relatively large amount of drug
19. Pt allergic to morphine should not take codeine because they are chemically related and
because codeine is partially (10%) demethylated to morphine -- but it is OK with
meperidine (demerol), pentazocine(talwin), methadone (dolophene), butorphanol
(stadol)

20. Propoxyphen has poor oral availability due to: poor release from dosage
form,metabolism in liver and gut wall, chemical degradation in dosage form
21. Promethazine is used with meperidine to relieve post-operative pain, inc its analgesic
effect
22. Phenobarbitone is a metabolite of primadone
23. Pethidine, opioid, not used as antitussive
24. Pemoline is used as stimulant drug in hyperkinesis with the advantage that can be taken
once daily
25. Naloxone: pure opiate antagonist
26. Naloxone: pure antagonist -- nalorphine: mixed agonist-antagonist
27. Naloxone treats opiate toxicity
28. Naloxone is used to reverse respiratory depression caused by opiates
29. Nalorphin (narcotic mixed agonist antagonist) has a disadvantage in ttt of codeine
dependence == pptn of withdrawal symptoms
30. Morphine toxicity cause constipation NOT diarrhea
31. Morphine cause constipation
32. Methanol oxidation = formic acid = retinotoxic = blindness
33. Methadone is a narcotic agonist
34. Meperidine + promethazine: postoperative analgesia
35. Longest acting opioid= methadone
36. Least addicting = nicotine
37. Fentanyl used in chronic bone metastasis
38. Endorphines, enkephalines are classified as peptides
39. Early signs of theophylline overdose: tachycardia
40. D-propoxyphene has 1/2 analgesic activity of codeine
41. D-propoxyphen: analgesic=1/2 codiene - L-propoxyphen: antitussive
42. Diphenoxylate is related to mepridine as it stimulates opiate center in GIT causing
constipation
43. Dextromethorphan is a narcotic cough suppressant
44. Dextromethorphan is a narcotic cough suppressant
45. Constipation due to norphine is ttt by : inc fiber content in diet, stool softener (Na
docusate), stimulant laxative, if constipation persists use osmotic laxative (Mg citrate or
lactulose)
46. Codeine is partially metabolized to morphine (demethylation) -- 15-20mg is effective as
antitussive
47. Codeine in methylmorphine, heroine is diacetylmorphine
48. Codeine dose: 30-60mg max: 200mg
49. Cocaine toxicity is : respiratory failure
50. Chlordiazepoxide is very effective in the ttt of alcohol withdrawal
51. Caffeine is of methylxanthines
52. Caffeine has diuretic effect
53. Advantage of naloxone over nalorphine is that it lacks agonistic action
54. Advantage of naloxone over nalorphine is lack of agonistic action
55. A potential advantage of pemoline over other stimulant drugs for uses in hyperkinesis
(minimal brain dysfunction) is that pemoline can be given once daily
56. (cont. pemoline) pemoline, aschedule IV controlled substance, has been recently
introduced for the ttt of MBD. While it's no more effective than either
dextromethorphan or methylphenidate , it certainly approaches these drugs in terms of
efficacy,
57. (cont. pemoline) pemoline has a slower onset of clinical activity than either
dextroamphetamine or methylphenidate. Improvement may not be observed for 3-4
weeks, consequently the drug shouldn't be discontinued before it has been given a
reasonable trial
58. (cont. pemoline) and has the advantage of a longer t1/2, permitting a once-a-day
dosing, this is desirable because multiple day dosing often creates problems associated
with drug administration while the child is in school
59. (cont. pemoline) although dextroamphetamine was the preferred drug for MBD for
many years, methylphenidate has become the DOC largely because of unjustified fears
that the use of dextroamphetamine may predisposeone to subsequent abuse
60. Pethidine(mepridine) take care it comes a lot in exam ,pethidine is the British name-and
Australians adopt the British nomenclature -and you will find it in comprehensive under
the name mepridine because it is the American name exactly like paracetamol-British-
and acetaminophen-American- which refers to the same compound try to know
everything about it at least 5 Q's in the 2 papers
61. Pethidine metabolite is toxic
62. Morphine is synthetic opioid
63. Methadone is morphine agonist
64. Diphenoxylate similar to pethidine
65. What is true about Pethidine?a) makes more dependent than other Opioids b) makes
less dependent than other opioids c) makes more spasms in the sphincter of Oddi d)
seizures
66. Treatment of constipation in longterm opioid-treatment..a) Senna...b)Docusate..c)
Psyllium..d) Bisacodyl..e) Sodium Picosulfate
67. Metamucil with opioid cause blockage
68. Cannaboid- the other name is Tetrahydrocannabinol..- the other name is
dancannaboid..- doesn't has medical use..-dronabinol is isomer of trtrahydrocannabinol
69. Morphine does not need loading dose
70. Group responsible for water solubility of Nicotine … nitrogen
71. Active metabolite of Morphine
72. Acamprostate duration of treatment in alcoholism : at least 3 months
73. What is true about Pethidine?a) makes more dependent than other Opioids b) makes
less dependent than other opioids c) makes more spasms in the sphincter of Oddi (or
something like that) d) seizures
74. Treatment of constipation in longterm opioid-treatment a) Senna b) Docusate c)
Psyllium d) Bisacodyl e) Sodium Picosulfate
75. Opioids doesn’t cause what?..Ans. Diarrhoea
76. Opiods.....which one is not a side effects of opioids.
77. Metamucil with opioid cause blockage
78. Drug that decreases pain, anxiety and load on heart: aspirin, morphin, furosemide,
digoxin and ACEI…
79. Diphenoxylate similar to pethidine
80. Cannaboid- the other name is Tetrahydrocannabinol - the other name is dancannaboid -
doesn't has medical use -dronabinol is isomer of trtrahydrocannabinol
81. Alcohol + CNS depressant = increase depression
82. Amphetamine urinary excretion is increased by administration of ammonium chloride
83. Disulfuram, metronidazole interfer with alcohol metabolism

NSAIDs recalls

1. Vertigo, tinitus are side effects of aspirin only appear in toxicity


2. TXA2 could be inhibited by indomethacin
3. The most essential group in sulindac is: sulfide
4. Sulindac: NSAID
5. Sulindac is a prodrug: sulfoxide is reduced to the active sulfuide
6. Pyridium: red discoloration of urine
7. Piroxicam: ttt of morning stiffness
8. Piroxicam: drug that is usually given to relief the morning stiffness pain
9. Piroxicam is used for morning stiffness because of long t1/2
10. Piroxicam has a long t1/2: 36hrs
11. Phenylbutazone has long t1/2 (75-100 hrs) and cause aplastic anemia and blood
dyscrasias, it also displace other drugs from plasma proteins
12. Pentazocin: strong analgesic pain killer
13. Pentazocin: strong analgesic pain killer
14. Paracetamol has NO antiinflammtory effects
15. NSAIDs # PG synthesis
16. NSAID with longest duration of action: piroxicam
17. Naproxen taken once daily
18. Naproxen is arylalkanoic derivative useful in arthritis pts who has difficulty in
remembering to take the medication during the day
19. Large doses of acetaminophen may cause hepatic necrosis
20. Indomethain can cause salt and water retention with HTN pt leading to frontal
headache
21. Indomethacin: used in chronic arthritis pain ttt
22. Indomethacin is similar in structure to sulindac
23. Indomethacin frequent use: headache
24. Indomethacin cause frontal headache
25. Indomethacin admn immediately after food
26. Indometahcin frequent use:: headache
27. Indocin (indomethacin) take with milk, meals or antacids or immediately after food to
reduce gastric irritation
28. In aspirin toxicity we use NaHCO3 to increase excretion
29. Ibuprofen is less toxic than naproxen
30. High doses of acetaminophen cause hepatic necrosis
31. Gold - naproxen - penicillamine - ibuprofen,, of all listed: ibuprofen has the least SE
32. Dose of sulindac is 100-200 mg
33. Dose of aspirin in rheumatic fever: 6g
34. Diflunisal is not metabolized into salicylic acid within the body
35. Diflunisal : prodrug
36. Dicofenac is phenylacetic acid derivative, sulindac, indomethacin
37. Chronic use of APC tablets (aspirine + phenacitin + caffeine) leads to analgesic
nephropathy -- it is more associated with phenacitin rather than aspirin -- it may also be
assoc w aspirin, antipyrine, aminopyrine and phenacetin
38. Aspirin may induce asthma, may interact with sulfonylureas but NOT interact with
MAOIs
39. Aspirin is water insoluble
40. Aspirin antiplatelet action is due to inhibition of TXA2
41. Advantage of peroxicam over other NSAIDs is that it is given once daily -- naproxen :
twice daily
42. Decrease COX activity increases thromoxane production
43. Aspirin is sparingly soluble in water
44. If a mother of two children was prescribed 125mg/ml paracetamol in solution then the
child of 8 years old has to take 4times a day and then if she can use the same solution
for the otherchild of 2 years old ehat could be the dose for the second child?
45. What toxic dose of paracetamol cause? Hepatic and renal failure was Answer
46. Which one is not cox 2 selective: piroxicam
47. Which one has higher water solubility:-methyl salicylate-acetylsalicylic acid-salicylamide-
sodium salicylate
48. What is the mechanism of aspirin - inhibit cox
49. Paracetamol dose for child 20 kg: 300 mg qid
50. Paracetamol dose in child weighing 20kg: 300mg qid
51. Metabolism for ibuprofen
52. Which one is not cox 2 selective: piroxicam
53. Which one has higher water solubility: -methyl salicylate -acetylsalicylic acid -
salicylamide -sodium salicylate
54. Which is not correct for aspirin: aspirin in soluble in water.
55. Which doesn’t have active metabolite?...Aspirin
56. What is the mechanism of aspirin - inhibit cox
57. Pt complains of tooth ache, he had sports injury and had been on naproxen for one
week. What would you do appear from refering to dentist: Add ibup, give him PCM,
replace naproxen with PCM…
58. Paracetamol dose for child 20 kg: 300 mg qid
59. Child dose (daily) of paracetamol
60. Some doses of aspirin: normal maximum dose is 4g a day but in rheumoid arthritis the
dose may be oral 2.6-6.5 g a day in divided doses. In acute rheumatic fever, up to 7.8 g a
day in divided doses may be given ??
61. Sulindac is prodrug (sulphoxide is reduced to the active sulfide) more active by prodrug
62. Salicylates cause: metabolic acidosis, alkaline diuresis, electrolyte imbalance, GIT
bleeding (ttt vit K+ fresh frozen plasma)
63. Phenylbutazone has longest t1/2 (100 hrs), cause blood dyscrasias, also displace some
drugs from plasma proteins
64. Indomethacin SE: Na and water retention, hyperkalemia, aplastic anemia
65. Indomethacin is contraindicated with HTN as it cause frontal headache - indomethacin
cause Na and H2O retention - epinephrine , nitrates cause throbbing headache
66. Chronic use of APC (Aspirin 400mg + paracetamol 200mg + caffeine anhydrous 50mg.
)tablets may result in analgesic neuropathy
67. What toxic dose of paracetamol cause? Hepatic and renal failure was Answer
68. Aspirin, ibuprofen displace warfarin BUT acetaminophen DOESNOT
69. Maximum safe dose of paracetamol is 4gm/day

Nutrition recalls

1. TPN is stored 2-8 C for not more than 24 hrs


2. TPN fluids should be stored between 2-8 DC
3. Tetany occur due to hypocalcemia
4. Storage of fats, formation of scar tissue, polymerization of aminoacids are called
anabolism
5. Ringer soln: NaCl + KCl + CaCl2 + H2O
6. Parentrally administered electrolytes are usually ordered in milliequivalents
7. Parentral administration of 1 L of 5% dextrose in H2O provide pt with 170-200
kilocalories
8. Na normal level in blood=135-146 mmol/L -- K normql level in blood=3.5-5.5 mmol/L
9. Na level in blood: 135-146 mmol/L - K level in blood: 3.3-5.5 mmol/L
10. Marasmus: protein deficiency
11. Lytren: an electrolyte supplement used to replenish electrolytes lost as a consequence
of a diarrheal condition NOT: K-lyte, Potassium Triplex, Kaon, Kayxelate.. Lytren is oral
soln containing: dextrose, KCl, Na, Ca, Mg salts
12. Low Na intake may cause Li toxicity - low sodium intake may cause lithium toxicity
13. Lefenalac is a dietary product used in pt with phenylketonuria
14. kwashiorkor: malnutrition
15. K normal value= 3.5 - 5 mEq/L
16. K is nor present in dry fruits
17. Hyperkalemia leads to :: bradycardia, paralysis, paresthesias --- hypokalemia leads to::
dry mouth, tachycardia, muscle cramps
18. Homopolysaccharides: starch, glycogen, cellulose --- heteropolysaccharides: heparine,
hyalouronic acid
19. Glucose and fructose are monosaccharides
20. Glucose an fructose are monosaccharides
21. Gelatin is a protein
22. fats provide the largest amount of calories per gram more than ethanol, anhydrous and
hydrous dextrose and proteind. Fats provide 9kcals/g. because of their isotonicity, fat
emulsions can be safely adminstered through peripheral veins
23. Fats provide the greatest number of calories per gram
24. Fats give the highest calory per gram; 1g=9kcals --1g protein=1g carbohydrate=4kcals --
1g dextrose=3.4kcals
25. Essential amino acids: lysine, leucine, isoleucine, histidine, valine, phenylalanine,
arginine, methionine, threonine, tryptophan
26. Essential amino acids must be supplied with diet
27. Essential amino acids are to be supplied with diet
28. Dextrose is used in parentral solution for transfusion
29. Carbohydrates and fats are alike because they release energy to the cell ‫حاجة حلوة بصراحة‬
30. Anabolism is: biosynthetic (build up), fat storage, polymerization of amino acids
31. 1L D5W gives 170-200 kcals
32. 1gm protein= 4kcals -- 1gm carbohydrate= 4kcal -- 1gm fat= 9kcal
33. (cont. TPN) sudden discontinuation of glucose soln may cause rebound hypoglycemia in
response to the sudden elimination of the sustained glucose load of the
hyperalimentation solution.
34. (cont. TPN) it's best to maintain the pt on a nominal amount of dextrose such as D5W or
to slowly wean the pt from the TBN soln
35. (cont. TPN) hyperosmotic nonketotic hyperglycemic causes include too rapid infusion
rate, dextrose soln that are too concentrated and malfunction of pancreatic secretion of
insulin
36. (cont. TPN) hyperchloremic metabolic acidosis may occur during hyperalimentation
therapy when the total Cl ion content is high. The amino acids in the protein salts are
usually Cl or HCl salts.
37. (cont. TPN) additional amounts of Cl are obtained when NaCl or KCl are added to the
hyperalimentation solns. It may be useful to add simply Na or K as acetate salts
38. (cont. Lytren) it's used to supply water and electrolytes in a balanced proportion in
order to prevent serious deficits from occuring to pts suffering from mild to moderate
fluid loss.
39. (cont. kcal, TPN) hydrous dextrose provides 3.4kcals/g. it's the usual source of calories in
TPN because of its safety, economy and availability to the body. Proteins provide 3-
4kcals/g
40. (cont. fats, TPN) a commercial example of a fat emulsion in intralipid, a 10% soybean
emulsion. Ethanol provide 7kcal/g it has disadvantages: too-rapid infusion can cause
heart-burn &/or intoxication, it can't be used in pts with GI disease ex.pancreatiti

41. TPN solution should be refrigerated


42. A man on tea and toast diet likely to develop iron deficiency anemia
43. TPN doesn’t contain Vit-K.
44. Ricinoleic ( castor oil ) of linoleic ( unsaturated )
45. Oleic acid= monounsaturated organic acid --- linoleic acid= poly unsaturated organic
acid
46. Oleic acid: monounsaturated fatty acid --- linoleic acid: polyunsaturated fatty acid
47. Linoleic acid: polyunsaturated fatty acid
48. Lanolin contains more water than wool fat

Parkinson recalls

1. With levodopa we give domperidone to counteract dopaminergic GIT SE.


2. Vit B6 is C.I. with L-dopa because it is a cofactor in the enzyme dopa-decaroxylase thus
inc the peripheral decarboxylation of levodopa giving a metabolite unable to cross the
BBB -- so pts on L-dopa should avoid OTC multivitamine preparations
3. Vit B6 in C.I. with levodopa
4. Sinemet (carbidopa + levodopa in a ratio, 1:10) carbidopa dec the dose of L-dopa by
about 75% -- L-dopa 1g qid can be replaced by sinemet 25/250 qid
5. Selegline is selective MAOI b, used in parkinsonism
6. SE of L-dopa: diplopia, dark urine, o.hypotension
7. Pt on carpidopa and levodopa complain of dark urine discoloration of levodopa
metabolite
8. Procyclidine is anticholinergic used in parkinsonism
9. Parkinsonism: inc in Ach, dec in dopamine, assoc with muscle regidity
10. Parkinsonism may be induced by : haloperidol, resepine, chlorpromazine, methyldopa
11. Muscle regidity is one of parkinsonism symptoms
12. L-dopa SE: hypotension
13. L-dopa is a dopamine precursor used in the ttt or parkinsonism; C.I. with B6: dec
antiparkinsonism action, MAOI: hypertensive crisis, anticholinergics: synergism
14. L-dopa does NOT cause HTN
15. Haloperidol is NOT used in parkinsonism
16. Haloperidol in C.I. with parkinsonism
17. Haloperdoil, vit B6: are C.I. with parkinsonism
18. Four clinical features of parkinsonism: tremor, disturbances of posture, bradykinesia,
rIgidity BUT NOT mental deterioration
19. Ethopropazine is a phenothiazine derivative used in the ttt of parkinsonism due to its
atropine like action
20. Ethopropazine is a phenothiazine derivative that has atropine like action so used in ttt of
parkinsonism
21. Drugs causing parkinsonism: haloperidol, phenothiazines, reserpine, heavy metal
poisoning, methyldopa
22. Carbidopa (alpha-methyldopa hydrazine) # peripheral dopa decarboxylase and does not
cross BBB
23. Bromocriptine: dopamine agonist -- chlorpromazine: dopamine antagonist
24. Benztropine mesylate is an anticholinergic that is useful in ttt of morning stiffness and
rigidity assoc with parkinsonism due to its long duration of action so it can be taken at
bedtime
25. Baclofen is antispastic
26. All of the following are clinical manifestations of parkinsonism: tremor,
bradykinesia,disturbance of posture, and regidity BUT NOT mental deterioration
27. A dopamine agonist used to treat hyperprolactinemia: bromocriptine, it is an ergot
alkaloid derivative that acts on the anterior pituitary to supress prolactin secretion
28. (continue parkinsonism) or festination (an involuntary increase or hastening in
gait,generally in a stooped position
29. (cont. parkinsonism) tremor is a rhythmical alternating contraction of a given muscle
group and its antagonist
30. (cont. parkinsonism) rigidity is an increased muscle tone that is resistent to passive
movement of an extremity
31. (cont. parkinsonism) postural disturbances are positive disturbances include difficulty in
maintaining an upright position of the trunk while standing or walking also
retropulsion(tendency to walk backwards
32. (cont. parkinsonism) bradykinesia is slow or etarded movement. There is a deminishe
spontaneous movement, loss of normal associative movement and slowness in initiation
of all voluntary movements
33. (cont. parkinsonism) aged people with parkinsonism may have impairment of memory
and judgement or have mental disturbances due to other disease states or social
isolation but not due to parkinsonism
34. (cont. bromocriptin) The drug may be indicated in the ttt of amenrrhea and galactorrhea
assoc with hyperprolactinemia. It's available as 2.5mg tablets and the usual therapeutic
dose is 1 tab 2 or 3 times daily.
35. Seligiline: selective reversible MAOB inhibitor
36. Benztropine use in parkinsonism: tremors and rigidity
37. Patient with low dopamine and high ACH..Which symptoms he does not have: - tremors
– rigidity – bradykinesia – akathisia – hyperreflexia
38. Parkinsons due to less dopamine in which are: (substantia nigra)
39. MAO B inhibitors in Parkinson’s: Selegiline
40. Inc. in dopamine and dec. in ach … name the condition .. Symptoms are except …
hyperflexia- bradikinesia -ataxia tremors
41. Which one of the following is the side effect of Levodopa ....Ans. Hypertension
42. What is Selegiline......Ans. MAO-B
43. Seligiline: selective reversible MAOB inhibitor
44. Patient with low dopamine and high ACH Which symptoms he does not have: - tremors
– rigidity – bradykinesia – akathisia – hyperreflexia
45. Parkinsons due to less dopamine in which are: (substantia nigra)
46. In Huntington: not enough GABA
47. Bromocriptine… galactorrhea
48. Benztropine use in parkinsonism: tremors and rigidity
49. in Huntington: not enough GABA
50. Physician's Desk Reference:: list products manufactured by Paul B. Elder Co. - Possible
identification of a capsule having a distinctive color combination
51. (cont. PDR) the PDR is divided into several sections, one of which lists pharmaceutical
companies with the product manufactured by each. The PDR has a colored plate
reference section that pictures products for easy indentification
52. (cont. PDR) that section is subdivided by individual manufaturers

Peptic ulcer recalls

1. Zollinger-Ellison syndrome: marked hypergastrinemia, gastric hypersecretion, peptic


ulceration caused by a gastrin producing tumor of pancreas or duodenum wall
2. Theophylline is C.I. with cimetidine
3. TC, imidazoles, sucralfate should not be taken with food or antacids
4. Sucralfate should not be taken with food or antacids
5. Sucralfate should NOT be taken with food or antacids
6. Sucralfate is not absorbed from the GIT
7. Ranitidine would NOT produce iatrogenic (drug-induced) HTN
8. Ranitidine dose is 150 mg bid
9. Parietal cells in stomach secrete HCl and intrinsic factor
10. NaHCO3 = systemic antacid
11. Magaldrate gel is given q1hr in duodenal ulcer
12. Ketoconazole, FeSO4 should not be taken with antacids
13. KCL is given in enteric coated tablets to protect gastric mucosa from irritation
14. K used as SR ( wax matrix ) as it is very irritant to GIT
15. If pt is taking theophyllin and cimetidine theophylline dose should be decreased or pt
could shift to ranitidine or other H2 blocker that have no effect on hepatic enzymes
16. Ideal antacid should inc PH of stomach to 3.5
17. Ideal antacid raises the gastric PH to 3.5 -- rising from 1 to 3.5 neurtalizes 99% of the
gastric acid -- any higher PH serves no useful purpose
18. HCl secretion receptors: M, H, gastrin … HCl is secreted from parietal cells
19. Dose of mesoprostol for ttt of ulcers: 800 mg daily (2-4 divided doses)
20. Critical interaction between cimetidine and ranitidine???
21. Cimitidine SE: gynecomastia
22. Cimetidine is C.I. with: theophylline, phenytoin, warfarine, carbamazepine
23. Cimetidine is C.I with theophylline, phenytoin, warfarin, carbamazepine
24. Cimetidine is associated with gynecomastia and mental cofusion in the elderly
25. Cimetidine interaction:: inc effect of every thing ( ‫) الحیاة‬- dec the effect of ketoconazole
and phenothiazines -- antacids dec cimetidine effect
26. Cimetidine inc dose at bedtime
27. Cimetidine in elderly cause: mental confusion, gynecomastia-- cimetidine large dose is
taken at bedtime
28. Cimetidine causes gynecomastia in elderly patients
29. Cimetidine # HME
30. Antacids: inc L-dopa absorption
31. Antacids dec A of: cimetidine, ranitidine, INH, digoxin, phenthiazines, iron, sucralfate,
anticholinergics, TC, quinolones
32. What is the dose for misoprostol for ulcer ?a.20mg 4 times a dayb.200microgram 4times
a day
33. Sucralfate compounding calculation from sample question 2014 (6.67 %)
34. Which cells secrete HCL: Parietal cells
35. Misoprostol dose for peptic ulcer: 200mcg qid
36. Which one of this has no drug interactions?Ans: Omeprazole + warfarin
37. Which cells secrete HCL: Parietal cells
38. H2 Receptor antagonist + Ketoconazole.......decreases absorption from gut.
39. H.pylori infection......

Physiology recalls

1. Drugs causing photosensitivity: amiodarone, amitriptyline, doxepine,


fluoxetine,furosemide, griseofulvin, isotretenoin, ketoprofen, nalidixic acid, naproxen,
OC, oral hypoglycemics, piroxicam, phenothiazines, sulfonamides, TC, thiazides,
trimethoprim"
2. Atresia: absence of a hole
3. Xerostomia= dryness of mouth
4. Xerostomia: dryness of mouth
5. Weak acids, bases are more absorbed from small intestines due to large surface area
6. Weak acids and bases are more absorbed from the small intestines due to large surface
area, most drugs are from the duodenum
7. Venoclysis is assoc with IV infusion
8. Trypsinogen is produced by pancreas
9. Thirst is controlled by hypothalamus
10. The substance secreted in the stomach and present in the intestine is: mucous NOT
pepsin
11. The part of ear responsible for balance is the inner ear
12. The outer waterproof layer of skin in made of keratin
13. The epidermis is made of keratin
14. Tests::: acid fast: mycobacteria -- Rideal walker, phenol coefficient, chick martin:
disinfectants --- mantox, tuberculin, PPD : TB --- Schick's: diptheria --- Ames:
carcinogenicity
15. Sweat is used for: water excretion, Na excretion, temperature equlation (the most
important)
16. Sweat function: water excretion, Na excretion, temperature regulation
17. Stomatitis: inflammation of the oral mucosa -- blepharitis: inflammation of the eyelid --
gastritis: inflammation of the stomach wall -- glossitis: inflammation of the tongue
18. Stomatitis is inflammation of the oral mucosa
19. "Stenosis: narrowing or stricture of a duct or canal -- aortic stenosis: narrowing of the
20. aortic orifice of the heart -- pyloric stenosis: abstruction of the pyloric orifice of the
stomach
21. caused by hypertrophy of the pyloric muscle"
22. Steatorrhea:: fatty acide deficiency due to improper secretion of bile acid
23. Steatorrhea is excessive loss of fats in feces
24. Sphingomyelin: building unit of nerve
25. Sarcolemma in striated muscles and nervous tissues
26. Retro: backward -- retrograde means retrace of a former course
27. Retinol: reproductive -- retinal: visual -- retinoic: epithelial
28. Respiratory center is located in medulla
29. Related to body muscles: myalgia, myocardia, myoclonus, myositis BUT NOT myopia
30. Radial artery is used to measure pulse rate --- brachial artery is used to measure blood
pressure
31. Pyuria=pus in urine
32. Prefixes:: cata: downward, dis: apart, infra: below, meso: middle, retro: backward, celi:
abdomen, cephal: head, col: large intestines, cor: heart, cost:rib
33. Portagen is dietary product used in the ttt of steatorrhea
34. Portagen is a dietary product used to treat pts with steatorrhea. It's a product used
when conventional dietary fats may not be well absorbed , digested or utilized
35. polyphagia: excessive graving for food -- hirsutism: abnormal hairiness -- urticaria is
commonly called hives -- nystagmus: involuntary rapid movement of the eyeball which
may be horizontal, vertical, rotarory or mixed
36. PH of the small intestines: 6.2 -- a drug with pka 6.2 will be 50% ionized at the small
intestine (PH 6.2)
37. PH of skin is 5.5
38. Outer layer of skin (stratum corneum) is made up of keratin
39. Nospital infections=nosocomial
40. Neutral compound absorbed from lipid biological membrane depends on partition
coefficient
41. Myopia: nearsightedness -- myalgia: pain in a muscle --myocardia pertains to the heart
muscle -- myoclonus is muscular twitching or conraction -- myositis is inflammation of a
voluntary muscle
42. Meso: middle -- mesobronchitis indicates inflammation of the middle coat of the
bronchi
43. Meniere's disease: deafness, tinnitus and dizziness, this is a nonsuppurative disease of
the labyrinth
44. Meniere's disease: deafness, tinnitus and dizziness
45. Major buffer of extracellular fluid is HCO3/CO2 system
46. Large surface area of small intestine enhance absorption
47. Ischemia: deficiency of blood in a part of the body -- myocardial ischemia: deficiency in
blood supply to the heart muscle --- icterus: jaundice
48. Inner ear is responsible for equilibrium
49. Ileum is the last part of small intestine
50. Hypertrophy: an enlargement of overgrowth of an organ -- hyperplasia: abnormal inc in
cell number of a tissue -- hyperhidrosis: excessive sweating/perspiration --
hyperkinesia:(excessive movement) -- hypersthesia: excessive sensitivity to stimulus
51. Hyperhydrosis: excessive hydration or sweat -- hypersthesia: excessive sensitivity of
skin-- lethargy: sleepness -- polyphagia: inc appetite -- pyuria: inc pus in urine
52. Hodgkins disease affects lymphoidal tissue. There is a progressive enlargement of lymph
nodes, spleen and other lymphoid tissue
53. Dyspnea: difficult or labored breathing -- dysphagia: difficulty in swallowing --dyspepsia:
impairment of digestive function -- dysuria: painful or difficult urination -- dysphoria:
restlessness
54. Dysarthria: difficulty of speech
55. Diseases and areas::: Adam's-Stoke's disease:heart, addison's disease: adrenal gland,
Bright's disease: kidney- Hodgkin disease: lymph nodes, myasthenia gravis: muscles,
Goiter: thyroid, acromegaly:pituitary gland, Klinefelter's syndrome:testis
56. Dis: apart -- disarticulation is amputation or separation of a joint
57. Cost: rib -- intercostal: located between two ribs
58. Correct order: Blood-ureter-bladder-urethra
59. Conjugated proteins are those found in nature combined with a nonprotein substance.
Examples include the lipoproteins such as licithin and sterols, which consist of proteins
combined with lipids
60. Colististiken : cofactor liberated from d. mucosa after ingestion of meat ot fat
61. Col: large intestine -- coloproctitis: inflamation of colon and rectum
62. Cholic acid aids in fat absorption
63. Children 3-10 years old have low acidity skin thus may have skin infection
64. Children 3-10 y have low acidity skin thus may have skin infection
65. Cephal: head -- cephalalgia: headache
66. Central vein is used for infusion of hypertonic solutions, postoperative hydration, poor
access to peripheral veins
67. Celi: abdomen -- celiotomy is incision into the abdominal cavity
68. Cata: downward -- catabolism indicates any destructive process by which complex
substances are converted by living cells into more simple compounds
69. Cartilage covers and protects bone from friction during normal joint activity
70. Car: heart -- the pericardium: the region over the heart
71. Bile conjugation ocurs in liver
72. Bacteriuria: greater than 100000 bacteria/ml
73. Axon is part of the neuron that carries impulses away from the nerve cells
74. Ataxia: poor muscle coordination
75. Aseptic pencil is used in minor cuts
76. Areas and diseases::: cushing syndrome: adrenal cortex, Stein-leventhal syndrome:ovary
77. Aphasia: inability to communicate
78. Anatomy of small intestines: duodenum, ileum, jejunum
79. Amylase, trypsin are secreted from pancrease
80. Absorption occurs in the ileum
81. (cont. portagen) its fat content consists of 95% medium-chain TGs, which are more
rapidly absorbed than the long-chain fatty acids present in conventional food fats. Pts
suffering steatorrhea are excellent candidates to portagen dietary supplementation
82. % of body water at birth is 80%, normal 70%
83. % of body water at birth is 80%
84. Which substance is mostly found in the urine?a) Uric acid b) Urea c) Albumin
85. Absorption is faster in which part of GIT?.... Ans. Small Intestine

Polypeptides recalls

1. Polypeptides advantage:-selectivity-CNS availability


2. Polypeptide therapy benefit…. Specific target
3. Polypeptides advantage: -selectivity -CNS availability
4. Damage of protein and peptides due to: -deamination -oxidation
Renal Failure recalls

1. The presence of impaired renal function in pt:: dec the requirements for drugs that are
diectly excreted or whose active metabolites are excreted by the kidney
2. The amount of glomerular filterate reabsorbed: 85-99%
3. Serum creatinine= 0.6-1.2 mg/ dL
4. Pyelonephritis is accompanied with edema
5. Oliguria= dec urine excretion
6. Oliguria= dec in urine excretion
7. Normal CrCl: 80-120 cc/min
8. More than 80% of water and Na are reabsorbed from the proximal tubules
9. More than 50% of water is reabsorbed in the proximal tubules --- K reabsorption in the
ascending limb of distal tubules
10. More than 50% of water are reabsorbed from the proximal tubules by passive transport
11. Kidney dysfunction: inc (BUN) blood urea nitogen
12. K reabsorption occurs in the proximal tubules but K secretion occurs in the distal tubules
13. K reabsorption is from the ascending limb of distal tubules
14. In nephritis there is edema
15. Glucose is completely reabsorbed after GF
16. Examples of drugs that don't need dose adjustment in renal failure : linezolide,
fosinopril,digitoxin,clonidine, cefoperazone, Infliximab,TNFα inh
17. Edema occur with nephritis
18. Drugs excreted by glumerular fileration: TC, aminoglycosides, digoxin, ethambutol,MTX,
19. Drugs excreted by GF: ethambutol, aminoglycosides, MTX, digoxin, procainamide --
drugs excreted by passive tubular secretion: aspirin, amphetamine -- drugs excreted by
active tubular secretion: penicillin
20. Drugs excreted by GF: ethambutol, aminoglycosides, methotrexate, digoxin,
procainamide
21. Dosage adjustment in renal impaired pts is based on serum Cr concentration
22. Degraded TC gives a more toxic form = fanconi like syndrome
23. Creatinine, inulin: measure GFR
24. Creatinine clearance is used to assess the hepatic function with normal value 75-
120ml/min
25. CrCl=100-120cc/min
26. CaCO3 is given to pt with terminal renal failure to inc. Ca in serum, correct hypocalcemia
27. CaCO3 is given in renal failure to treat hypocalcemia and dec phosphate
28. CaCO3 is given in renal failure to dec PO4 conc
29. Ca acetate : ttt of hyperphosphatemia in end stage renal failure
30. Bright's disease is a term used to describe kidney disease characterized by proteinurea
and glomerulonephritis
31. 5% of glomerular filteration returns to blood from distal tubules
32. 180 L/day of fluid filtered in GF per day
33. Urine output per day is 1500 ml
34. Glucose reabrosped by tubules
35. Which substance is mostly found in the urine?a) Uric acid..b) Urea...c) Albumin
36. Which one is mostly reabsorbed from renal tubules: glucose
37. Glomerular filtration due to hydrostatic pressure
38. Aluminum in renal failure used for: phosphate
39. Which one is mostly reabsorbed from renal tubules: glucose
40. Renal failure? What are the possible symptoms
41. Glomerular filtration due to hydrostatic pressure
42. Aluminum in renal failure used for: phosphate
43. NaHCO3 inc rate of urinary excretion of penicillin G K, penobarbital Na
44. Na benzoate, Na phenyl acetate, : inc ureagenesis

Schizophrenia recalls

1. Thioridazine is a phenothiazine derivative with the least


extrapyramidal SE (3)
2. The therapeutic value of the electroconvulsive therapy (ECT) is due to
the convulsion itself
3. Tardive dyskinesia is irreversible SE of phenothiazine.(2)
4. Quetiapine (atypical antipsychotic) : SE: cataract
5. Pt on haloperidol should not take alpha methyl dopa or alcohol(3)
6. Promethazine is a potent antiemetic (2)
7. Phenothiazines:: chlorpromazine, thioridazine, fluphenazine,
trifluperazine, perphenazine
8. Phenothiazines SE is parkinson like
9. In antemenetic effect chloropromazine is greater than promethazine
which is greater than fluperazine
10.Haloperidol is C.I. with methyldopa or guanthedine
11.Haloperidol + alpha methyl dopa= life threatening reaction
12.Fluphenazine deconate is mainly given IM(2)
13.Fluphenazine deconate is a flophenazine ester, formulated in oil
vehicle and injected deeply into the muscle, the ester slowly diffuses
into circulation and has a prolonged duration of action
14.Droperidol is butyrophenone derivative that is used as adjunct to
anesthesia.
15.Chloropromazine does NOT cause vomiting.
16.Chlorpromazine: relieve pre-surgical apprehension
17.Chlorpromazine inc 1 and 1/2 when given IM
18.Chlorpromazine has longer duration when given IM(3)
19.Chlorpromazine causes extrapyramidal effects
20.Chlorpromazine bioavailability is increased when taken parentrally
IM
21.Benztropine is given with phenothiazines as benztropine is
anticholinergic thus dec extrapyramidal SE of phenothiazines
22.Antacid should be taken 1 hr before CPZ or 2 hrs after
23.AlOH3 in C.I with TC, cholropromazine
24.All phenothiazines have extrapyramidal SE except thioridazine
25.Quetiapine block 5HT receptors
26.Promethazine : phenothiazine(2)
27.Olanzapine given by IM depot
28.Flupenthixol given by IM injection
29.Drugs causing neuroleptic malignant syndrome
30. Which one antipsychotic has the least extra pyramidal side effects
31.Increase in DOPA, decrease in Acetyl Choline............Ans. Tardive
Diskinesia.
32.Haloperidol is NOT used in parkinson's (2)
33.Patient on haloperidol should not take alcohol or alpha methyl dopa
Side effects recalls

1. Some phototoxic drugs: amiodarone, sulphonamides, TC, thiazides, phenothiazines,


nalidixic acid
2. Side effects::: spironolactone:gynecomastia-- nadolol, bronchospasm -- alpha
mehyldopa: +ve coomb's test -- sulfisoxazole: steven johnson syndrome -- rifampicin:
discoloration of urine, sweat, contact lens
3. SE:::: spironolactone: gyncomastia -- guanethidine: orthostatic hypotention --
methyldopa: positive coomb's test -- sulfisoxazole : steven's johnson syndrome --
rifampicin: discoloration of body fluids -- dececlocyclin: photosensitivity
4. SE:: hydralazine: SLE -- prazosin: 1st dose syncope -- guanethidine: orthostatic
hypotention, drug-induced inhibition of ejaculation
5. Photosensitizers: thiazides, phenothiazines, fluoroquinolone, amiodarone, TC
6. Photosensitivity is caused by: TC, nalidixic acid, piroxicam, chlorpromazine
7. Hydralazine, procainamide SE : SLE
8. H.M.E inducers: phenobarbitone, glutethimidine, EtOH, carbamazepine --- H.M.G
inhibitors: phenylbutazone, benzodiazepines, INH, dicumarol, chloramphenicol,
estrogen
9. Drugs that are C.I. with myathenia gravis:: procainamide, quinidine, aminoglycosides,
dtubocurarine, phenytoin
10. Drugs causing SLE: hydralazine, procainamide, quinidine, TC, methyldopa, penicillamine,
phenytoin, phenothiazines, sulfonamides, INH, nitrofurantoin, ethosuximide
11. Drugs causing gynecomastia: spironolactone, ketoconazole, digitalis, cimetidine
12. Drugs causing disulfuram like action: sulfonyl ureas (except: tolazamide, glimepride),
cefotetan, cefoperazone, cefamandole, moxolactam, metronidazole, INH,
chloralhydrate, nitrofurantoin
13. Disulfuram like reaction: metronidazole, sulfonylurea, cephalosporines, cloralhydrate,
disulfuram, ketoconazol
14. Cyclobenzaprine and amitrptyline have the same side effects
15. Corticosteroids and estrogen caused HTN while ranitidine does NOT
16. Diseases and symptoms:: Raynaud's disease:cold pallor or cyanosis of fingers or toes--
Grave's disease: exophthalmus and enlargement of the thyroid gland--herpes
simplex:watery blisters on skin and mucous membranes espicially the lips

Thyroid recalls

1. Tyrosine is precyrsor of thyroxin


2. Tyrosine is precursor of thyroxine
3. Tyrosine is a thyroxine precursor
4. Tyrosine is a precursor of thyroxine
5. Thyroxine secretion from thyroid gland is regulated by iodine level in blood
6. Thyroxine secretion from thyroid gland is regulated by iodine level in blood
7. Thyroxine metabolism: deiodinization, then conjugation, then excretion
8. Thyroxin release can be controlled by TSH (thyroid stimulating hormone)
9. Thyroxin interactions: inhance effect of anticoagulants, antagonizes insulin and inc
requirements of hypoglycemics, cholestyramine dec thyroxin absorption
10. Thyrotoxicosis is ttt by : PTU (propylthiouracil) and carbimazole
11. Thyroid storm= sudden onset thyrotoxicosis
12. Thyroid preparation after surgical removal of thyroid gland:1.6mcg/kg/day
13. Thyroid hormone: dec vit K dependant clotting factors thus potentiate warfarin
14. Thyroid hormone is responsible for: protein synthesis, inc activity of Na-K ATPase pump
to inc O2 consumption, stimulate secretion of growth hormone
15. Thiocyanate dec iodide uptake in thyroid gland
16. Thiocyanate affect iodine uptake in thyroid gland
17. The bromsulphalein (BSP) excretion test is a measure of thyroid function
18. PTU is preferred in ttt of hyperthyrodism because PTU inhibits peripheral conversion of
T4 to T3, which may theoritically make it more effective in the ttt of thyroid storm
19. Propylthiouracil, carbimazole:: ttt of hyperthyrodism
20. Propylthiouracil is the best antithyroid
21. Propylthiouracil is preferred over carbimazole as antithyroid
22. Propylthiouracil is better than carbimazole because it blocks peripheral conversion of T4
to T3 beside inhibition of T4,T3 synthesis
23. Normal thyroid level is called euthyroid
24. Myxedema is decreased secretion of thyroid hormone in adulthood
25. Myxedema coma: is ttt by large initial dose of T4 and T3, corticosteroids are also given
for the posibility of central hypothyrodism ?? .. T3 is the DOC in acute case because of
its quick onset of action.
26. Myxedema (dec thyroxin in adults) can be caused by: Li or amiodarone
27. Methimazole in pregnants: agranulocytosis
28. Methimazole in pregnants: agranulocytosis
29. Li, amiodarone: interfer with thyroid gland function
30. Li and amiodarone both interfer with the function of the thyroid gland
31. Iodine uptake by the thyroid gland is inhibited by high iodine dose
32. Hypothyroid in adults is called: myxedema
33. Hypothyrodism due to Li therapy is a rare case
34. Graves disease: enlragement of the thyroid gland, exophthalmus, acceleration of pulse
rate, sweating, nervousness, psychatric disturbances, emaciation and increased
metabolic rate
35. Grave's disease is a form of hyperthyrodism --- thyroid storm is sudden onset of
thyrotoxicosis
36. Exophthalmus is seen in Grave's disease hyperthyrodism
37. Exophthalmus is protrusion of the eye associated with hyperthyrodism, hyperplasia of
thyroid gland
38. Exophthalmos is seen in Grave's disease hyperthyrodism
39. Excessive thyroid secretion causes thyrotoxicosis
40. Excessive thyroid secetion = thyrotoxicosis
41. Euthyroid=normal thyroid
42. Drugs that prevent the uptake of iodine: prechlorates, thiocyanates, iodine in high doses
43. Dose of thyroxine=50-150 mcg daily
44. Dose of thyroid peparation in adult after surgical removal of the thyroid gland is 1.6
mcg/kg/day
45. Antithyroids = propylthiouracil , carbimazole
46. 100 mg of thyroxin is equivaent to 25mg of triiodothyronine
47. Thyroid gland releases a hormone, which controls? Rate metabolism
48. Thyroid ADR with which drugs: amiodarone and lithium

Toxicology recalls

1. When urinary pH inc= excretion of acids inc


2. Vomiting = alkalosis --- diarrhea = acidosis
3. Urine alkanlinizer is not given when the pt is on erythromycin
4. Universal antidote: charcoal + MgO + tannic acid
5. ttt of hyperkalemia:: if there's no ECG change: rectal Napolystyrene sulfonate -- if
there's ECG change: IV calcium -- emergency: IV NaHCO3 or IV glucose + insulin
6. Trimethoprim is not C.I. is sulfa allergy but captopril is
7. Symptoms of disulfuram reaction: throbbing headache, sweating, chest pain,
hyperventilation, weakness, vertigo, blurred vision, BUT NOT severe diarrhea
8. Salicylic acid excretion is increased by alkaline urine and forced diuresis
9. Pulmonary toxicity is SE of: bleomycin, amiodarone, nitrofurantoin, pentamidine,
bromocriptine
10. Pts with sulfa allergy could take safely:: etahcrynic acid or spironolactone as diuretic,
sulfamethizol (bec of short t1/2)
11. Pregnant woman cannot use TC
12. Pregnancy: X , D , C, B , A
13. Pregnancy X: Li, vitamin A, isotretinoin, TC, ACEIs, warfarin, alcohol,
finasteride,misoprostol, metronidazole, phenytoin???
14. Phenytoin , theophylline have narrow therapeutic index
15. NaHCO3 is given after shock to neutralize lactic acid, regulate respiration due to CO2
accumulation, replace plasma
16. NaHCO3 ampoules are sterilized by ultrafilteration - NaHCO3 is used to neutralize lactic
acidosis
17. NaHCO3 + 5% dextrose= acidosis as a result of diarrhea
18. NaHCO3 : ttt of lactic acidosis , ampoules sterilized by ultrafiltration , ttt of acidosis
(cardiac arrest )
19. Na cellulose phosphate : ttt of hypercalciuria
20. Mephenesin carbamate is antidote for strychnine
21. In urine PH inc, excretion of salicylic acid inc
22. In cardiogenic shock we give NaHCO3 to treat ventilation acidosis
23. In barbiturate or salicylate toxicity give urine alkalinizer as NaHCO3 or acetohexamide
24. In acidosis ( cardiac arrest ) we give NaHCO3
25. Idiosyncrasy is NOT dose related
26. Hypersensitivity and idiosyncrasy is not dose related
27. Hemodyalisis is used for polar drugs
28. Hemodialysis for polar drugs
29. EDTA is used as Ca salt because it binds to body Ca causing Ca loss
30. Drugs pregnancy category X: isotretenoin, TC, misoprostol, finasteride, chloamphenicol,
methimazole, coumadin, metronidazole, VPA, Li, alcohol
31. Drugs causing pulmonary fibrosis as SE: tocainide, amiodarone
32. Disulfuram # oxidation of ethanol to acetic acid
33. Dimercaprol is sparingly soluble in H2O when when complexed with heavy metals form
stable non-toxic compound which is excreted from kidney
34. Dicobalt edetate is antidote for CN --- Ca edetate is antidote for Pb (lead)
35. Desferrioxamine chelates iron
36. Cyanosis = bitter almond breath
37. Cyanide toxicity is due to cytochrome oxidase enzyme
38. Cool tar cause photosensitization, carcinogenic in rectal, genital, groin
39. Complex formed between BAL and dimercaprol is stable, stable in water, not toxic,
excreted
40. Charcoal can not adsorb FeSO4, CN, boric acid, DDT
41. Boric acid is NOT used in neonates
42. BAL or dimercaprol are antidotes for : Hg, Au, Cu, Sb, arsenic
43. Antidotes:: paracetamol: N-aceycysteine -- ehylene glycol, methanol: IV ethanol,
femopizol --heparine: protamine SO4 -- warfarin: vitamin K + fresh frozen plasma -- TCA
(anticholinergic): physostigmine -- BZD: flumazenil
44. Antidotes:: iron:desferroxamine -- lead: calcium EDTA, dimercaprol --Li:
decontamination, ipecac, bowel irrigation, Na polystyrene sulfonate -- opiates:naloxone,
naltroxone -- organophosphates: atropine, pralidoxime
45. Antidotes:: cyanide: amylnitrate, Na nitrate, Na thiosulfate -- digoxin: fab antibodies
(digibind), colestyramine, phenytoin or lidocaine (for arrythmia) -- Mg: CaCl2 10% -- K:
NaHCO3, glucose+insulin --
46. Antidotes:: B-blockers: epinephrine + glucagone (heart stimulant)-- CaCBs: IV Ca +
glucagone (heart stimulant)-- glucagone can only be given SC or IM but not IV
47. After vomiting alkalosis occur due to HCl loss-- after diarrhea acidosis occur due to HCO3
loss
48. Acidification of urine: inc ionization of alkaline drugs (e.g amphetamine): dec
reabsorption: inc its excretion
49. Acidification of urine increases excretion of alkaline drugs like amphetamine as
ionization increases thus reabsorption decreases
50. 8.4% NaHCO3 soln is give IV for cardiac arrest
51. 8.4% is alcohol shock to neutralize lactic acidosis ???
52. 8.4 % NaHCO3 in alcohol shock to neutralize lactic acidosis
53. Increase conc NH4cL increases excretion of amphetamine (basic)
54. EDTA is comlexing agent
55. Cool tar has photosenstizing action
56. Methotrexate overdose is managed by?a.folic acid...b. folinic acid( also known as
leucovorin)...c. naltrexone
57. Drug that worsens skin sunburns? Doxycyxline-ketocoazole-....
58. Methotrexate toxicity treat with leucovorin
59. Alkalization of urine used to increase elimination of :- acetyl salicylic acid- morphine-
dopamine- codeine
60. Drug of choice in Methotrexate toxicity: Folinic acid- folic acid
61. Which medication should be given with food?
62. Case study: MTX related questions, antidote, increased hydration.
63. Alkalization of urine used to increase elimination of : - acetyl salicylic acid - morphine -
dopamine - codeine
64. Nothing will happen if we mix NaHCO3 to D5W
65. NaHCO3 is used to neutralize lactic acidosis
66. K toxicity ttt: NaHCO3, glucose+insulin, Na polystyrene sulfonate
67. In alkalosis we give acetazolamide - in acidosis we give NaHCO3
68. Acetycysteine is ineffective in ttt of paracetamol toxicity if taken after 12 hrs
69. Charcoal is decolorizing agent and adsorbing agent in toxicity
70. Urine discoloration drugs: rifampin, phenazopyridine, L-dopa, senna, phenolpthalin,
sulfasalazine, deferroxamine mesylate200mg FeSO4.2H2O=325mg FeSO4.7H2O=65mg
elemental iron
71. Sb (antimony) K tartarate is antiemetic anthelmentic
72. Na: the cation most prevalent in the extracellular fluid -- K: the cation prevalent in the
intracellular water
73. Na polystyrene is a cation exchane resin used in excretion of K
74. Epson salt: MgSO4 -- gilbert salt: Na2SO4 -- russel salt: KH tartarate
75. EDTA chelates Ca , Pb -- BAL :arsenic, gold, copper
76. Colloidal Hg: diagnosis of syphilis -- colloidal Au: diagnosis of paresis -- colloidal Cu:
diagnosis of cancer -- colloidal AgCl, AgI, Ag protein:: germicide
77. Colloidal Hg: diagnisis of syphilis -- colloidal Au: diagnosis of paresis --- colloidal Cu:
diagnosis of cancer --- colloidal AgCl, AgI,Ag protein: germicide
78. Antimony potassium tartarate is used as: antiemetic, anthelmentic

Vaccines recalls

1. Tetanus toxoid is given every 10 years


2. Tetanus toxoid booster dose every 10 years
3. Tetanus interval is 10 years
4. Tetanus antitoxin: does NOT give active immunity
5. Tetanus antitoxin does not give active immunity
6. Smallpox vaccine must be stored at 0 C (freezed)
7. Measels vaccine is given to 1 year old child (12-15 month)
8. Measels vaccine is given to 1 y old
9. Measels vaccine is given to 1 y child
10. Immune serum globulin is injected by IM
11. Diphtheria vaccine and tetanus toxoid give active immunity
12. Diphtheria gives active immunity
13. Botulism antiserum is passive immunity
14. Botulinum antitoxin: passive immunity -- typhoid vaccine: active immunity
15. Bacillus Calmette-Guerin (BCG) vaccine: is a viable strain of Mycobacterium bovis which
has been used for immunization against TB. More recently it has been used as a
nonspecific adjuvant or immunostimulant in cancer chemotherapy
16. (cont. BCG vaccine) MOA is the activation of macrophages to make them more effective
killer cells in conjunction with lymphoid cells
17. (cont. BCG vaccine) macrophages activation with BCG vaccine appears to inc the rate of
clearance of immune complexes (antibody-soluble tumor antigen) from the blood
18. Which is not active immunity? DPT

Virology recalls

1. Vidarabin is used in the ttt of herpes simplex encephalitis


2. ttt of shingles: acyclovir
3. ttt of choice for herpes simplex of eye lid and conjunctiva is idoxuridine, BUT in skin:
acyclovir
4. "The diagnostic element in blood for AIDS pt is antibody for HIV detected by ELISA
5. assay"
6. Reverse transcriptase inhibition: efavirenz, didanosine, zidovudine, stavudine,
nevirapine, abacavir, zalcitabin
7. Retrovir=AZT=zidovudine --- SE hematologic suppression, agranulocytosis
8. Restriction endonuclease: cut double DNA of virus
9. Restriction endonuclease enzyme: cut DNA
10. PCP (Pneumocystis Pneumonia) in HIV pts ttt by pentamidine
11. Nelfinavir (cross BBB) # protease
12. Mononucleasis + ampicillin therapy = rash
13. Lamivudine is reverse transcriptase inhibitor used in HIV
14. Herpse simplex: watery blisters on skin and mucous membranes, espicially the lips
15. Foscarnet (antiviral) : ttt of CMV (cytomegalo virus) SE: renal failure
16. Didanosine: longest duration, least BMD
17. Acyclovir is used in the ttt of herpes simplex
18. Which of this medication does not have an active metabolite- famcyclovir – valaciclovir-
acyclovir-lamivudine
19. Which one of these is act by nucleoside reverse transcriptase in treatment of HIV-
lamivudine - atazanavir- indinavir- efavirenz
20. Which mechanism of efavirenz : non nucleoside reverse transcriptase inhibitor
21. Shingles : viral infection of nerve root
22. Question about colony stimulating factor, which is wrong:-it is antiviral
23. NRTI: Lamivudine
24. Cidovofir question, select wrong option?
25. Which one of these is act by nucleoside reverse transcriptase in treatment of HIV -
lamivudine - atazanavir - indinavir - efavirenz
26. Which of this medication does not have an active metabolite - famcyclovir – valaciclovir-
acyclovir-lamivudine
27. Which mechanism of efavirenz : non nucleoside reverse transcriptase inhibitor
28. Treatment of Varicella Zoster Virus..Which treatment duration is correct? Eg. 4 days, 21
days, 7 days, 18 days.......Ans. 7 days
29. Shingles : viral infection of nerve root
30. Question about colony stimulating factor, which is wrong:-it is antiviral
31. MOA of saquinavir… hiv protease enzyme inh.
32. Classification of Anti-HIV drugs. X drug belongs to which class?

Vitamins recalls

1. Zinc deficiency causes: growth retardation, hair loss, nausea, loss of appetite
2. Vitamin H: biotin: ttt of skin disorders
3. Vitamin E is used as antioxidant (oily)
4. Vitamin E is insoluble so it is better formulated as suspension in heavy mineral oil
5. Vitamin E is called tocopherol used as antioxidant found in nut
6. vitamin D1: cholcalciferol, it occurs naturally in cod liver oil, can be formed in the skin by
action of the UV --- vitamin D2: calciferol, it does NOT occur naturally, used in the ttt of
ricketsia, osteomalacia
7. Vitamin D is used in hypoparathyrodism
8. Vitamin D is not decomposed by sunlight - but vitamin C does
9. Vitamin D is controls absorption os Ca and PO4
10. Vitamin C is metabolized to oxalic acid
11. Vitamin C is aromatic carboxylic acid
12. Vitamin B9: folic acid
13. Vitamin B6 is a detoxifying agent esp: alcohol and phenytoin
14. Vitamin B6 dec levels of L-dopa , alcohol , phenytoin
15. Vitamin B12 contains cobalt
16. Vitamin A is soluble in fatty acids
17. Vitamin A is important for reproduction in man NOT vitamin E
18. Vit K: phytonadione: ttt of hemorrhage
19. Vit E is sol in: fixed oil, ether, chloroform
20. Vit E is not proved to be essential for reproduction in man but vit A is important
21. Vit E is insol so it is better to be formulated in heavy mineral oil
22. Vit D: calciferol : ttt of ricketssia, and hypoparathyrodism
23. Vit D is NOT used in hyperthyrodism
24. Vit C inc iron absorption
25. Vit C inc Fe absorption by maintaining it in the ferrous state and forming a soluble and
absorbable chelate with iron in the ferric state -- doses of 500-1000mg inc Fe absorption
by about 10% -- smaller doses are not recommended (neglecible inc in A)
26. Vit B6: pyridoxine: used with INH to dec peripheral neuritis, inc extracellular metabolism
of levodopa, ttt of sideroblastic anemia, used with cyclizin for ttt of vomiting induced in
pregnancy
27. Vit B6 is contraindicated with levodopa, parkinsonism, phenytoin
28. Vit B6 dec serum level of phenytoin, alcohol, levodopa
29. Vit B1: thiamine: ttt of beriberi -- vit B2: riboflavin: precursor for FAD, NAD -- vit B3:
niacin: antihyperlipiemia -- vit B5: panthothenic acid; paralytic ileus???
30. Vit B1 (thiamine) is heat labile
31. Use of vitamine E in deodorants is antioxidant
32. Thiamine (B1) deficiency: Wernicke's syndrome or Korsakoff's or beri-beri with
peripheral neuropathy and confusion
33. Thiamin (vit B1) is heat liable
34. Soluble vit A is used in the form of veg. oil
35. Pregnant women should take foilc acid
36. Pellagra: niacin deficiency --- scurvy: ascorbic acide deficiency -- pernicious anemia:
cyanocobolamine deficiency
37. Nicotinic acid ttt of pellagra, agranulocytosis, dermatitis, hyperlipidemia
38. Mineral oil impair vit K absorption
39. K1=phytonadione --- K2= menadione
40. GSH (glutathion, antioxidant) protect RBCs, hemoglobin from oxidation
41. Folic acid with iron is used for folate deficiency in pregnant women
42. Folic acid is given to pregnants to prevent spina bifida
43. Fish liver oil contains vitamins A,D
44. Ferric iron is the iron form least absorbed from intestine
45. Fat sol vitamins: ADEK
46. Cod liver oil contains vit A and vit D
47. Cholcalciferol is vitamin D3 is produced in the skin from 7-hydroxycholesterol by UV
radiation it is main function to inc Ca absorption from intestine, inc bone formation,
mineralization
48. Cholcalciferol (vit D3): is sterosteroid produced in skin from 7-dehydrocholesterol by UV
radiation, it is main function is to inc Ca absorption from intestine and inc bone
formation and mineralization
49. Ascorbic acid: rapidly absorbed from the GIT, utilized at high rates in common cold and
infections, protects from scurvy, reversibly oxidized to oxalic acid
50. Ascorbic acid: rapidly absorbed from GIT, it is utilized at increased rate during infection,
protects against scurvy, reversibly oxidized to oxalic acid ??
51. Ascorbic acid is a lactone structure
52. Ascorbic acid is a lactone structure
53. Ascorbic acid acidifies urine
54. Ascorbic acid acidifies the urine
55. 1,25-dehydrocholcalciferol enhance Ca absorption
56. 1,25 dihydroxycholcalciferol in Ca absorption
57. 1,25 dihydroxy cholcalciferol aid in Ca absorption
58. Fat soluble vitamins have pronounced toxicity
59. Which Calcium form is not given as oral supplement?a) Ca Gluconate...b) Ca
Carbonate..c) Ca Lactate..d) Ca Succinate..e) Ca Chloride
60. 1,25 Dihydroxy-Vitamin D is a) Ergocalciferol b) Cholecalciferol c) Calcitriol
61. Vitamin E is rarely deficient in men
62. Vitamin D has steroid structure
63. Ascorbic acid with methenamine for urinary cystitis
64. Ascorbic acid REVERSIBLE conversion to oxalic acid is the wrong option
65. 1,25 dihydroxy cholecalciferol: increases Ca absorption + vit D synthesis
66. Which Calcium form is not given as oral supplement? a) Ca Gluconate b) Ca Carbonate c)
Ca Lactate d) Ca Succinate e) Ca Chloride
67. Vit-D is not destroyed by wht? Ans. Sunlight.
68. 1,25 Dihydroxy-Vitamin D is a) Ergocalciferol b) Cholecalciferol c) Calcitriol
69. Na in serum is 310-340 mg%

Vomiting recalls

1. Trimethobenzamide : antiemetic # CTZ


2. Metoclopramide: IV bolus
3. Metoclopramide is administered before aspirin to inc gastric emptying and inc aspirin
absorption
4. Metoclopramide is a prokinetic agent used as an antiemetic through: effect on CTZ, inc
rate of gastric emptying
5. Metoclopramide can be given by IV bolus
6. Metachlorpropamide is antiemetic
7. Dronabinol: antiemetic, appetite stimulant
8. Dolasetron, ondansetron, granisetron : antiemetics
9. Dolasetron C.I. with : hypokalemics, hypomagnesemics, antiarrythmics
10. Antimony potassium tartarate (tartar emetic) is emetic and anthelmentic: tartar emetic
is intravenously administered anthelmentic agent which is employed against:
schistosoma japonicum/mansoni/haematobium
11. (cont. tartar emetic) it was once considered an outstanding emetic. However, it's no
longer used for this purpose because of its slow action and toxicity. Doses of 200 mg are
fatal, usual emetic dose is 30mg
12. Which drug against Nausea is not used in Pregnancy?
a)Pyridoxine...b)Diphenhydramine...c)Metoclopramide...d)Prochloperazine
13. Question about metoclopramide antiemetic effects, but need to select the wrong one
out of 4 options
14. Which drug against Nausea is not used in Pregnancy? a)Pyridoxine b)Diphenhydramine
c)Metoclopramide d)Prochloperazine
15. Metoclopramide: which is not the probable ADR (vomiting)
16. Metoclopramide......which one of the following is not a side effect?
17. Metoclopramide MOA, Ondansetron MOA, dexamethasone MOA (Antiinfl)
18. Metaclop causes ADR that needs monitoring.. tardve dyskinesia
19. pencillins lose their activity by hydrolysis NOT oxidation, reduction
20. Nitrates: dec preload -- hydralazine, diazoxide: dec afterload -- Na nitroprusside: dec
preload + afterload

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